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BMJ. 2008 Jul 3;337:a346. doi: 10.1136/bmj.a346.

Cardiovascular evaluation, including resting and exercise electrocardiography, before participation in competitive sports: cross sectional study.

Author information

1
Department of Medical and Surgical Critical Area, Thrombosis Centre, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy. francescosofi@gmail.com

Abstract

OBJECTIVE:

To evaluate the clinical usefulness of complete preparticipation cardiovascular screening in a large cohort of sports participants.

DESIGN:

Cross sectional study of data over a five year period.

SETTING:

Institute of Sports Medicine in Florence, Italy.

PARTICIPANTS:

30,065 (23,570 men) people seeking to obtain clinical eligibility for competitive sports.

MAIN OUTCOME MEASURES:

Results of resting and exercise 12 lead electrocardiography.

RESULTS:

Resting 12 lead ECG patterns showed abnormalities in 1812 (6%) participants, with the most common abnormalities (>80%) concerning innocent ECG changes. Exercise ECG showed an abnormal pattern in 1459 (4.9%) participants. Exercise ECG showed cardiac anomalies in 1227 athletes with normal findings on resting ECG. At the end of screening, 196 (0.6%) participants were considered ineligible for competitive sports. Among the 159 participants who were disqualified at the end of the screening for cardiac reasons, a consistent proportion (n=126, 79.2%) had shown innocent or negative findings on resting 12 lead ECG but clear pathological alterations during the exercise test. After adjustment for possible confounders, logistic regression analysis showed that age >30 years was significantly associated with an increased risk of being disqualified for cardiac findings during exercise testing.

CONCLUSIONS:

Among people seeking to take part in competitive sports, exercise ECG can identify those with cardiac abnormalities. Follow-up studies would show if disqualification of such people would reduce the incidence of CV events among athletes.

PMID:
18599474
PMCID:
PMC2453296
DOI:
10.1136/bmj.a346
[Indexed for MEDLINE]
Free PMC Article

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