Heart Centre, Amsterdam University Medical Centers, AMC Amsterdam, the Netherlands.
Sports Medical Centre Papendal, Arnhem, the Netherlands.
Eur J Prev Cardiol. 2020 Sep;27(14):1529-1538. doi: 10.1177/2047487319901060. Epub 2020 Jan 29.
Structured electrocardiography (ECG) analysis is used to screen athletes for high-risk cardiovascular conditions (HRCC) to prevent sudden cardiac death. ECG criteria have been specified and recommended for use in young athletes ≤ 35 years. However, it is unclear whether these ECG criteria can also be applied to master athletes >35 years.
The purpose of this study was to test whether the existing ECG criteria for detecting HRCC in young athletes can be applied to master athletes.
We conducted a cross-sectional study among athletes >35 years screened for HRCC between 2006 and 2010. We performed a blinded retrospective analysis of master athletes' ECGs, separately applying European Society of Cardiology (ESC)-2005, Seattle, and International criteria. HRCC were defined using recommendations from the international cardiac societies American Heart Association and American College of Cardiology, and ESC, based on ECG screening and cardiovascular evaluation (CVE).
We included 2578 master athletes in the study, of whom 494 had initial screening abnormalities mandating CVE. Atrial enlargement (109, 4.1%) and left ventricular hypertrophy (98, 3.8%) were the most common ECG abnormalities found using the ESC-2005 or Seattle criteria. Applying the International criteria, ST-segment deviation (66, 2.6%), and T-wave inversion (58, 2.2%) were most frequent. The ESC-2005 criteria detected more HRCC (46, 1.8%) compared with the Seattle (36, 1.4%) and International criteria (33, 1.3%). The most frequently detected HRCC was coronary artery disease (24, 0.9%).
ECG criteria recommended for use in young athletes can be applied to master athletes' ECGs to detect HRCC. The ESC-2005 criteria had the highest sensitivity for detecting HRCC among master athletes.
结构性心电图（ECG）分析用于筛查有高心血管风险条件（HRCC）的运动员，以预防心源性猝死。已经指定并推荐了 ECG 标准，用于≤35 岁的年轻运动员。然而，尚不清楚这些 ECG 标准是否也适用于>35 岁的大师级运动员。
本研究旨在检验年轻运动员中用于检测 HRCC 的现有 ECG 标准是否也适用于大师级运动员。
我们对 2006 年至 2010 年间筛查 HRCC 的>35 岁运动员进行了一项横断面研究。我们对大师级运动员的 ECG 进行了盲法回顾性分析，分别应用欧洲心脏病学会（ESC）-2005 年、西雅图和国际标准。HRCC 根据美国心脏协会和美国心脏病学会、ESC 的国际心脏协会的心电图筛查和心血管评估（CVE）建议定义。
我们纳入了 2578 名研究中的大师级运动员，其中 494 名最初的筛查异常需要进行 CVE。使用 ESC-2005 或西雅图标准，最常见的 ECG 异常是心房扩大（109 例，4.1%）和左心室肥厚（98 例，3.8%）。应用国际标准，ST 段偏移（66 例，2.6%）和 T 波倒置（58 例，2.2%）最为常见。ESC-2005 标准检测到更多的 HRCC（46 例，1.8%），而西雅图（36 例，1.4%）和国际标准（33 例，1.3%）则较少。最常检测到的 HRCC 是冠状动脉疾病（24 例，0.9%）。
推荐用于年轻运动员的 ECG 标准可应用于大师级运动员的 ECG 以检测 HRCC。ESC-2005 标准在检测大师级运动员的 HRCC 方面具有最高的敏感性。
