Division of Cardiology, University Hospital, Zurich, Switzerland.
Swiss Med Wkly. 2012 May 31;142:w13575. doi: 10.4414/smw.2012.13575. eCollection 2012.
In Switzerland, screening concepts for the prevention of sports-associated sudden cardiac death are still insufficiently established in the large group of competitive athletes who are not integrated in an Olympic- or other high-level squad. The aim of the present study was to objectively determine the current situation in this particular group of athletes concerning cardiac pre-competition screening and define specific features of an "ideal" Swiss screening concept. Based on these data, the feasibility and validity was tested by the implementation of an exemplary local screening programme.
A standardised questionnaire was completed by 1,047 competitive athletes of different ages and gender. The individual, sports-specific profile of an athlete and furthermore, the personal attitude towards and the vision of a "perfect" cardiac screening were assessed. Based on the results, an exemplary local screening programme for competitive athletes was implemented at the "Academic Sports Association Zurich" (ASVZ) in Zurich, Switzerland and evaluated 1 year after its introduction.
Only 9% of the 1,047 interviewed competitive athletes (aged 13 to 64 years; median age 22 years, SD = 5.87) had previously undergone a cardiac screening. Only 47% of the interviewed competitive athletes expressed their interest to undergo a cardiac screening at all. Male and older athletes showed a significantly higher acceptance rate for the screening programme than women and younger athletes. All athletes accepted to bear the expenses for the baseline screening programme, adapted to international standards (minimal accepted fee of 60 Swiss Francs). Almost half of the athletes (49.2%) preferred easy accessibility to a sports cardiologist (max. distance of 10 kilometres). The exemplary local screening programme proved to be feasible and successful. However, only 30% of the 102 screened individuals were female and most of the athletes (80%) who made use of the screening had a specific concern or symptom (selection bias). A total of 5 athletes (4.9%) were, at least temporarily, declared as not eligible for competitive sports due to a relevant cardiac pathology.
The fact that only 9% of the interviewed competitive athletes had previously undergone cardiac screening is alarming, but underlines the necessity and urgency of implementing a cost-effective and adequate screening concept in the enormous group of competitive athletes who are not integrated in an Olympic- or other high-level squad. The need for a certain self-determination and personal responsibility of the athletes should be respected. Therefore, the screening should not be mandatory. However, adequate information about the issue is crucial for an informed decision.
在瑞士，针对未被纳入奥林匹克或其他高水平队伍的竞技运动员这一庞大群体，运动相关性心源性猝死预防的筛查理念仍不够完善。本研究的目的是客观地确定该特定运动员群体在心脏赛前筛查方面的现状，并明确瑞士“理想”筛查理念的具体特征。在此基础上，通过实施一个具有代表性的当地筛查项目，对其可行性和有效性进行了检验。
对 1047 名不同年龄和性别的竞技运动员进行了标准化问卷调查。评估了运动员的个人、运动专项特征，以及他们对“完美”心脏筛查的态度和看法。根据结果，在瑞士苏黎世的“苏黎世学术体育协会”（ASVZ）实施了一个具有代表性的竞技运动员当地筛查项目，并在项目实施 1 年后进行了评估。
在接受采访的 1047 名竞技运动员中，只有 9%（年龄 13 至 64 岁；中位数年龄 22 岁，标准差 = 5.87）曾接受过心脏筛查。只有 47%的被采访竞技运动员表示他们有兴趣接受心脏筛查。男性和年龄较大的运动员比女性和年轻运动员更愿意接受筛查计划。所有运动员都愿意承担符合国际标准（最低可接受费用为 60 瑞士法郎）的基线筛查计划的费用。几乎一半的运动员（49.2%）更喜欢能够方便地接触到运动心脏病专家（最大距离 10 公里）。具有代表性的当地筛查项目被证明是可行和成功的。然而，在接受筛查的 102 人中，只有 30%是女性，大多数（80%）使用该筛查的运动员有特定的担忧或症状（选择偏倚）。由于相关的心脏病理学，共有 5 名运动员（4.9%）至少暂时被宣布不适合竞技运动。
接受采访的竞技运动员中只有 9%的人之前接受过心脏筛查，这令人震惊，但强调了在未被纳入奥林匹克或其他高水平队伍的庞大竞技运动员群体中实施具有成本效益和适当的筛查理念的必要性和紧迫性。应尊重运动员的某种自我决定和个人责任。因此，筛查不应强制进行。然而，关于该问题的充分信息对于做出明智的决策至关重要。
