Cardiovascular Center/Sports Cardiology, University Hospital Zurich, Zurich, Switzerland.
Br J Sports Med. 2013 Jun;47(9):579-84. doi: 10.1136/bjsports-2012-091803. Epub 2013 Mar 27.
Preparticipation cardiovascular (CV) screening has been advocated as an efficient strategy to reduce sudden cardiac death in Caucasian athletes. At present, uncertainty remains if such strategy is feasible and efficient in native African athletes. To this scope, we performed a CV screening in an African setting.
210 male Gabonian football players were examined with history, physical examination, ECG and echocardiography.
On history, 19 players (9%) referred atypical chest discomfort/oppression. Familial sudden death was referred by 36 (17%). No anomalies were detected at physical examination. ECG showed large proportions of 'training-related' abnormalities, that is, ST-segment elevation in precordial leads in 150 (71.4%), and isolated increase in R/S-wave voltage in 116 (55.2%). A substantial subset (12.4%) showed 'training-unrelated' abnormalities, that is, inverted T-waves in 10 (4.8%), left atrial enlargement in 8 (4%), deep Q-waves in 3 (1.4%). On echocardiography, one athlete meet criteria for hypertrophic cardiomyopathy (HCM); none showed evidence for arrhythmogenic right ventricular cardiomyopathy (ARVC) or dilated cardiomyopathy (DCM). Other abnormalities included mitral valve prolapse in three, atrial septal defect in two and pulmonary hypertension in one.
About 12% of native African athletes showed ECG abnormalities unrelated to training and requiring additional testing and periodical follow-up. Structural abnormalities were found, however, in a minority (5%), including HCM in one, but no ARVC or DCM. In conclusion, this study demonstrates that preparticipation CV screening is efficient to identify (or raise suspicion) for CV abnormalities in native African athletes, but challenging for conclusive identification of cardiac diseases in the difficult scenario of a developing African country.
在白种人群体中，运动员赛前心血管（CV）筛查已被证明是降低心源性猝死的有效策略。目前，这种策略在非洲裔运动员中是否可行和有效尚不确定。为此，我们在非洲环境中进行了 CV 筛查。
对 210 名加蓬足球运动员进行了病史询问、体格检查、心电图和超声心动图检查。
在病史方面，有 19 名运动员（9%）诉有非典型胸痛/压迫感。36 名运动员（17%）报告有家族性猝死。体格检查未发现异常。心电图显示出大量与“训练相关”的异常，即 150 名运动员（71.4%）胸前导联 ST 段抬高，116 名运动员（55.2%）孤立性 R/S 波电压增加。有相当一部分（12.4%）运动员表现出“与训练无关”的异常，即 10 名运动员（4.8%）T 波倒置，8 名运动员（4%）左心房扩大，3 名运动员（1.4%）深 Q 波。超声心动图显示，一名运动员符合肥厚型心肌病（HCM）标准；无运动员符合致心律失常性右心室心肌病（ARVC）或扩张型心肌病（DCM）标准。其他异常包括 3 名二尖瓣脱垂、2 名房间隔缺损和 1 名肺动脉高压。
约 12%的非洲裔本土运动员出现与训练无关的心电图异常，需要进一步检查和定期随访。然而，只有 5%的运动员发现了结构性异常，包括 1 名 HCM，但无 ARVC 或 DCM。总之，本研究表明，在非洲本土运动员中，赛前 CV 筛查可有效识别（或引起怀疑）CV 异常，但在发展中国家的困难环境下，对心脏病的明确诊断具有挑战性。
