Speers C, Seth A, Patel K, Gillett M, Rakhit D
Queen Elizabeth Hospital Birmingham, UK.
Br J Sports Med. 2017 May 10. doi: 10.1136/bjsports-2017-097827.2.
Sudden cardiac death is the leading medical cause of death during exercise. Our objective was to retrospectively analyse the routine cardiac assessment of professional footballers to aid physician management and improve player safety.
Footballers from five professional clubs between March 2012 and October 2014 were included (n=265). All were performed in line with the recommendations of the Football Association Cardiology Committee, incorporating clinical examination, 12-lead ECG, echocardiography and health questionnaire. Data was retrospectively collected, inspected and analysed using Excel spreadsheets. Findings were classified as 'normal' or 'not normal', and not normal assessments were further broken down into 'clear-cut pathology' (pathology with widely accepted guidance on management) or 'grey screen'.
Footballers were aged 13 to 37 years, with 69% aged over 18 and 31% under. The majority of the review population was White European (66%). Of the review population 11% had 'not normal' assessments, of these assessments 83% were considered grey screens (by Consultant Cardiologist) requiring further investigation or surveillance. Overall clear-cut pathology was identified in 2%.
A high proportion of the players (9%) had grey screens. The majority of these were due to ECG or structural abnormalities, which are clinically challenging to differentiate from physiological adaptation of the athletic heart and potentially fatal conditions. The extent to which these findings put the athlete at risk of a life threatening cardiac event is un-?quantified. Team physician's need to be aware of managing the on-going risk with these patients and ensure suitable ?follow up and assessment on a regular basis to mitigate this.
心源性猝死是运动期间主要的医学死因。我们的目标是回顾性分析职业足球运动员的常规心脏评估情况，以协助医生管理并提高运动员安全性。
纳入2012年3月至2014年10月期间来自五家职业俱乐部的足球运动员（n = 265）。所有评估均按照足球协会心脏病学委员会的建议进行，包括临床检查、12导联心电图、超声心动图和健康问卷。使用Excel电子表格对数据进行回顾性收集、检查和分析。结果分为“正常”或“不正常”，不正常的评估进一步细分为“明确病变”（有广泛认可的管理指南的病变）或“灰色地带”。
足球运动员年龄在13至37岁之间，69%的年龄超过18岁，31%的年龄在18岁以下。大多数被评估人群为欧洲白人（66%）。在被评估人群中，11%的评估结果为“不正常”，其中83%的评估被心脏病专家认为是灰色地带，需要进一步调查或监测。总体而言，明确病变的比例为2%。
相当比例的运动员（9%）存在灰色地带。其中大多数是由于心电图或结构异常，这些在临床上很难与运动员心脏的生理适应性以及潜在致命情况区分开来。这些发现使运动员面临危及生命的心脏事件的风险程度尚未量化。队医需要意识到对这些患者持续风险的管理，并确保定期进行适当的随访和评估以减轻这种风险。
