Maron B J, Bodison S A, Wesley Y E, Tucker E, Green K J
Cardiology Branch, National Institutes of Health, Bethesda, Maryland 20892.
J Am Coll Cardiol. 1987 Dec;10(6):1214-21. doi: 10.1016/s0735-1097(87)80121-3.
To determine the feasibility of detecting cardiovascular disease in a large group of young competitive athletes, a prospective screening evaluation of intercollegiate student athletes was undertaken at the University of Maryland. Initial clinical screening (including personal and family history, physical examination and 12 lead electrocardiogram) was performed in 501 athletes. Ninety of these subjects had positive findings on one or more of the three studies and agreed to further cardiologic evaluation. The vast majority (75 [84%] of 90) had no definitive evidence of cardiovascular disease, although 1 athlete had mild systemic hypertension and 14 (15%) had echocardiographic evidence of relatively mild mitral valve prolapse that had not been previously suspected. In three athletes with relatively mild ventricular septal hypertrophy (14 to 15 mm), it was not possible to discern with absolute certainty whether the wall thickening was a manifestation of hypertrophic cardiomyopathy or secondary to athletic conditioning ("athlete heart"). Therefore, this screening protocol identified no athletes with definite evidence of hypertrophic cardiomyopathy, Marfan's syndrome or other cardiovascular diseases that convey a significant potential risk for sudden death or disease progression during athletic activity. This failure to identify such diseases could have been due to a lack of sensitivity of the screening tests or to the low frequency with which these diseases occur in youthful healthy athletes. A systematic preparticipation screening program (such as the present one) does not appear to be an efficient means of detecting clinically important cardiovascular disease in young athletes.
为了确定在一大群年轻竞技运动员中检测心血管疾病的可行性，马里兰大学对大学生运动员进行了一项前瞻性筛查评估。对501名运动员进行了初始临床筛查（包括个人和家族病史、体格检查和12导联心电图）。其中90名受试者在三项检查中的一项或多项上有阳性发现，并同意进一步进行心脏评估。绝大多数（90名中的75名[84%]）没有心血管疾病的确切证据，尽管有1名运动员患有轻度系统性高血压，14名（15%）有超声心动图证据显示相对轻度的二尖瓣脱垂，此前未被怀疑。在三名有相对轻度室间隔肥厚（14至15毫米）的运动员中，无法绝对确定壁增厚是肥厚型心肌病的表现还是运动训练继发的（“运动员心脏”）。因此，该筛查方案未发现有肥厚型心肌病、马凡综合征或其他在运动活动期间有猝死或疾病进展重大潜在风险的心血管疾病的确切证据的运动员。未能识别此类疾病可能是由于筛查测试缺乏敏感性或这些疾病在年轻健康运动员中发生频率较低。一个系统的赛前筛查计划（如本计划）似乎不是检测年轻运动员临床上重要心血管疾病的有效手段。
