Sofi Francesco, Capalbo Andrea, Pucci Nicola, Giuliattini Jacopo, Condino Francesca, Alessandri Flavio, Abbate Rosanna, Gensini Gian Franco, Califano Sergio
Department of Medical and Surgical Critical Area, Thrombosis Centre, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
BMJ. 2008 Jul 3;337(7661):a346. doi: 10.1136/bmj.a346.
To evaluate the clinical usefulness of complete preparticipation cardiovascular screening in a large cohort of sports participants.
Cross sectional study of data over a five year period.
Institute of Sports Medicine in Florence, Italy.
30,065 (23,570 men) people seeking to obtain clinical eligibility for competitive sports.
Results of resting and exercise 12 lead electrocardiography.
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.
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.
评估在大量运动参与者中进行全面的运动前心血管筛查的临床实用性。
对五年期间的数据进行横断面研究。
意大利佛罗伦萨运动医学研究所。
30065名（23570名男性）寻求获得竞技体育临床资格的人。
静息和运动12导联心电图结果。
静息12导联心电图模式在1812名（6%）参与者中显示异常，最常见的异常（>80%）是良性心电图改变。运动心电图在1459名（4.9%）参与者中显示异常模式。运动心电图在静息心电图结果正常的1227名运动员中显示心脏异常。筛查结束时，196名（0.6%）参与者被认为不适合参加竞技体育。在筛查结束时因心脏原因被取消资格的159名参与者中，相当一部分（n = 126，79.2%）在静息12导联心电图上显示为良性或阴性结果，但在运动试验期间出现明显的病理改变。在对可能的混杂因素进行调整后，逻辑回归分析显示，年龄>30岁与运动试验期间因心脏检查结果被取消资格的风险增加显著相关。
在寻求参加竞技体育的人群中，运动心电图可以识别出有心脏异常的人。后续研究将表明取消这些人的资格是否会降低运动员心血管事件的发生率。
