Sudden cardiac death (SCD) is the leading cause of mortality in athletes during sport. A variety of mostly hereditary, structural or electrical cardiac disorders are associated with SCD in young athletes, the majority of which can be identified or suggested by abnormalities on a resting 12-lead electrocardiogram (ECG). Whether used for diagnostic or screening purposes, physicians responsible for the cardiovascular care of athletes should be knowledgeable and competent in ECG interpretation in athletes. However, in most countries a shortage of physician expertise limits wider application of the ECG in the care of the athlete. A critical need exists for physician education in modern ECG interpretation that distinguishes normal physiological adaptations in athletes from distinctly abnormal findings suggestive of underlying pathology. Since the original 2010 European Society of Cardiology recommendations for ECG interpretation in athletes, ECG standards have evolved quickly, advanced by a growing body of scientific data and investigations that both examine proposed criteria sets and establish new evidence to guide refinements. On 26-27 February 2015, an international group of experts in sports cardiology, inherited cardiac disease, and sports medicine convened in Seattle, Washington (USA), to update contemporary standards for ECG interpretation in athletes. The objective of the meeting was to define and revise ECG interpretation standards based on new and emerging research and to develop a clear guide to the proper evaluation of ECG abnormalities in athletes. This statement represents an international consensus for ECG interpretation in athletes and provides expert opinion-based recommendations linking specific ECG abnormalities and the secondary evaluation for conditions associated with SCD.

Sudden cardiac death (SCD) is the leading cause of mortality in athletes during sport. A variety of mostly hereditary, structural, or electrical cardiac disorders are associated with SCD in young athletes, the majority of which can be identified or suggested by abnormalities on a resting 12-lead electrocardiogram (ECG). Whether used for diagnostic or screening purposes, physicians responsible for the cardiovascular care of athletes should be knowledgeable and competent in ECG interpretation in athletes. However, in most countries a shortage of physician expertise limits wider application of the ECG in the care of the athlete. A critical need exists for physician education in modern ECG interpretation that distinguishes normal physiological adaptations in athletes from distinctly abnormal findings suggestive of underlying pathology. Since the original 2010 European Society of Cardiology recommendations for ECG interpretation in athletes, ECG standards have evolved quickly over the last decade; pushed by a growing body of scientific data that both tests proposed criteria sets and establishes new evidence to guide refinements. On 26-27 February 2015, an international group of experts in sports cardiology, inherited cardiac disease, and sports medicine convened in Seattle, Washington, to update contemporary standards for ECG interpretation in athletes. The objective of the meeting was to define and revise ECG interpretation standards based on new and emerging research and to develop a clear guide to the proper evaluation of ECG abnormalities in athletes. This statement represents an international consensus for ECG interpretation in athletes and provides expert opinion-based recommendations linking specific ECG abnormalities and the secondary evaluation for conditions associated with SCD.

Sudden cardiac death (SCD) is the leading cause of mortality in athletes during sport. A variety of mostly hereditary, structural, or electrical cardiac disorders are associated with SCD in young athletes, the majority of which can be identified or suggested by abnormalities on a resting 12-lead electrocardiogram (ECG). Whether used for diagnostic or screening purposes, physicians responsible for the cardiovascular care of athletes should be knowledgeable and competent in ECG interpretation in athletes. However, in most countries a shortage of physician expertise limits wider application of the ECG in the care of the athlete. A critical need exists for physician education in modern ECG interpretation that distinguishes normal physiological adaptations in athletes from distinctly abnormal findings suggestive of underlying pathology. Since the original 2010 European Society of Cardiology recommendations for ECG interpretation in athletes, ECG standards have evolved quickly over the last decade; pushed by a growing body of scientific data that both tests proposed criteria sets and establishes new evidence to guide refinements. On February 26-27, 2015, an international group of experts in sports cardiology, inherited cardiac disease, and sports medicine convened in Seattle, Washington, to update contemporary standards for ECG interpretation in athletes. The objective of the meeting was to define and revise ECG interpretation standards based on new and emerging research and to develop a clear guide to the proper evaluation of ECG abnormalities in athletes. This statement represents an international consensus for ECG interpretation in athletes and provides expert opinion-based recommendations linking specific ECG abnormalities and the secondary evaluation for conditions associated with SCD.

The cardiovascular health of this urban adolescent athletic population is a major concern because their rates of obesity and elevated blood pressure place them at increased risk of cardiovascular complications later in life despite their participation in school athletics.

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Introduction: Prostate cancer (PCa) is the most common cancer diagnosis among men in the United States. However, a vast majority of patients with PCa die of causes other than PCa, the most common being cardiovascular disease (CVD). We hypothesize that CVD-related mortality in PCa patients is disproportionately higher among Blacks as compared to Whites. Methods: We identified patients with PCa from the Surveillance, Epidemiology and End Results (SEER)-Medicare linked files between 1/1/2004 and 12/31/2015. The PCa risk groups were created based on the National Comprehensive Cancer Network criteria: low, intermediate, and high risk. The primary endpoint was CVD-related mortality. The following CVD conditions were included in the CVD-specific mortality: acute myocardial infarction, stroke, congestive heart failure, atrial fibrillation, and ischemic heart disease. A proportional hazards model that considered the competing risks was fitted to address the hypothesis. The model was adjusted for age, year of diagnosis, marital status, income level, SEER-region, state buy-in, radiation, surgery, and education level. Results: We identified 394,323 patients with PCa. Among these 80% were Whites, 15% were Blacks, and 5% were other races. The median age at diagnosis for Whites, Blacks, and other races was 69, 66, and 70 years, respectively. The incidence of CVD-related mortality was 5.6%, 6.6%, and 5% among Whites, Blacks, and Other races, respectively. Compared to Whites, Blacks had a significantly higher risk of mortality due to CVD across all PCa risk groups (Table). Similar results were not seen when the Other races was compared to Whites. Conclusion: Blacks with PCa have a significantly higher risk of mortality due to CVD as compared to Whites across all PCa risk groups. Our study highlights the importance of cardio-oncology in the setting of PCa. Further studies are warranted to confirm the findings. Table: Risk of CVD-related mortality among PCa patients; stratified by PCa risk group.Low-Risk (N=84,367)Intermediate-Risk(N=146,411)High-Risk(N=96,502)HR (95%CI); p-valueHR (95%CI); p-valueHR (95%CI); p-valueWhites(N=316,803)RefRefRefBlacks(N=58,046)1.23 (1.09-1.39); p<0.0011.24 (1.14-1.34); p<0.0011.09 (1.01-1.20); p=0.029Other Races(N=19,474)0.79 (0.60-1.04); p=0.0890.87 (0.74-1.03); p=0.1120.79 (0.69-0.91); p<0.001 Citation Format: Nikita Nikita, Joshua Banks, Scott Keith, Kosj Yamoah, Ulhas P. Naik, Felix J. Kim, David M. Shipon, Wm Kevin Kelly, Timothy R. Rebbeck, Grace Lu Yao. Racial disparities in death from cardiovascular disease for patients with prostate cancer: A population-based study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 780.

Introduction: Studies on adult athletes have found that caffeine consumption has both positive and negative effects on physical performance and cardiovascular physiology. While roughly 3 in 4 children older than 5 years old consume caffeinated beverages, the effects of caffeine on children and adolescent athletes are less studied. Methods: The HeartBytes National Youth Database produced by Simon’s Heart, a nonprofit organization that organizes pre-participation examinations (PPEs) of adolescents, was utilized for this study. This database contains demographic, exercise-related symptom (chest pain or dyspnea), and electrocardiogram data obtained during Simon’s Heart PPEs. Logistic regression models were adjusted for age, BMI, race, and gender except for the model assessing BMI as an outcome, which adjusted only for age, race, and gender. Results: Of the 7425 patients in the HeartBytes database, the majority were male (60.6%) and White (83.9%). The median age was 15.0 years old (interquartile range 13.5 - 16.5). Those who consumed caffeine were more likely to have a history of ADHD (adjusted odds ratio [aOR] 1.43 [CI: 1.15 - 1.76]; p = 0.001) and a BMI ≥ 30 (aOR 1.69 [CI: 1.27 - 2.25]; p < 0.001) when compared to non-caffeine drinkers. Caffeine drinkers overall were at no higher risk for exercise-related symptoms. However, when type of beverage was assessed, soda drinkers were more likely to have symptoms during exercise (aOR 1.33 [CI: 1.02 - 1.73]; p = 0.032) and coffee drinkers were more likely to have syncope with exercise (aOR 2.13 [CI: 1.20 - 3.60]; p = 0.006) compared to those who do not consume caffeinated beverages. No association was present between caffeine consumption or beverage type and ECG changes. Conclusions: In this dataset from a national registry of PPEs, caffeine consumption was independently associated with obesity and ADHD. While caffeine consumption itself did not increase risk of exercise-related symptoms, soda drinkers were at higher risk for symptoms during exercise, and coffee drinkers were at higher risk of syncope with exercise. The study shows that caffeine consumption may have significant impact on youth health. Future studies are needed to further confirm our findings.