Evidence for efficacy of the Italian national pre-participation screening programme for identification of hypertrophic cardiomyopathy in competitive athletes

Abstract

The Italian national pre-participation screening programme including 12-lead ECG appears to be efficient in identifying young athletes with HCM, leading to their timely disqualification from competitive sports. These data also suggest that routine echocardiography is not an obligatory component of broad-based screening programmes designed to identify young athletes with HCM.

Assessment of Mechanical Cardiac Function in Elite Athletes

“…Previous research conducted in regions of Italy that are well known for congenital cardiac complications have screened young athletes since the late 1970's to further reduce the rate of mortality [10]. However, there is much controversy in the literature as to whether preparticipation screening should be conducted on young athletes because of the low incidence rate of HCM, and the cost effectiveness of performing comprehensive testing [7,[11][12][13][14][15][16].…”

Morte súbita em atletas: protocolos e rotinas adotados por clubes de futebol profissional em São Paulo

“…Sudden cardiac death in athletes covers a wide age range, which goes from young athletes to individuals older than 35 years (1,2,(7)(8)(9)16) . In the present study, athletes' age ranged from 17 to 35 years, agreeing with the ages mentioned concerning onset of sudden cardiac death.…”

“…During 25 years, together with his collaborators, he developed research with the aim to identify the causal agents and its physiopathology, such findings were subsequently corroborated by further studies developed in many parts of the world (9,16) . As a consequence of this research, the European PreParticipation Protocol was designed, in which all athletes and non-athletes should be evaluated when engaging in a sports activity in order to early diagnose cardiac structural alterations which could end up in the onset of lethal arrhythmias and sudden cardiac death (9,16) . In Brazil, until 2004, when the death of a soccer player took place during a match of the national championship, there were not expressive discussions on sudden cardiac death in athletes.…”

“…According to the American Heart Association the echocardiogram would not be mandatory to all competing athletes, and the cardiovascular history and rest electrocardiogram of the athlete would be sufficient. The echocardiogram should be required only when in the presence of alterations in the electrocardiogram or in cases of family history positive for cardiovascular events (2,9,16) . Nevertheless, Corrado et al (2005) and Maron et al (2007) state that the evaluation based only on the anamnesis and on the physical exam is not sensitive enough to guarantee the detection of all cardiovascular anomalies linked to sudden cardiac death in athletes.…”

The Importance of the Electrocardiogram (Ecg) in the Setting of Sports Pre-Participation Screening

“…As demonstrated by Professor Domenico Corrado in an emblematic study [4], the ECG at rest is able to identify some heart diseases at an early stage in order to determine the risk of sudden death in athletes, with an extremely favourable cost/benefit ratio as it is very economic and because the ECG is an integral part of Italian athletical fitness tests for competition participation [5]. This is why being aware of and up to date with electrocardiographic changes, characteristic of well-trained athletes' hearts and in the specific alterations in heart disease more frequently implicated in causing sudden death, necessarily have to be part of every sports physician's medical knowledge.…”