Conway Justin J, Krystofiak Jason, Quirolgico Kristina, Como Brenda, Altobelli Anthony, Putukian Margot
Department of Sports Medicine, Crystal Run Healthcare, Newburgh, New York.
Department of Medicine, RWJBarnabas Health, Primary Care Sports Medicine, New Brunswick, New Jersey.
Clin J Sport Med. 2022 May 1;32(3):306-312. doi: 10.1097/JSM.0000000000000858. Epub 2020 Jun 10.
To: (1) analyze the results of 5 years of preparticipation cardiac screening including 12-lead electrocardiogram (ECG) of National Collegiate Athletic Association (NCAA) Division I athletes; and (2) assess the rates of ECG screening abnormalities and false-positive rates among 3 ECG screening criteria.
Retrospective chart review.
National Collegiate Athletic Association Division I University.
One thousand six hundred eighty-six first-year athletes presenting for their preparticipation examination including 12-lead resting ECG.
At the completion of the study period, all ECGs were retrospectively reviewed using the Seattle, Refined, and International Criteria.
(1) Prevalence of pathologic cardiac conditions identified by screening; and (2) number of ECG screening abnormalities by criteria.
Three athletes (0.2%) were found to have conditions that are associated with sudden cardiac death. Retrospective review of ECGs using Seattle, Refined, and International criteria revealed an abnormal ECG rate of 3.0%, 2.1%, and 1.8%, respectively. International criteria [odds ratios (OR), 0.58; P = 0.02] demonstrated a lower false-positive rate compared with the Seattle criteria. There was no significant difference in false-positive rates between the Seattle and Refined (OR, 0.68; P = 0.09) or the International and Refined criteria (OR, 0.85; P = 0.5).
There was a low rate of significant cardiac pathology in this population, and no athletes were permanently restricted from play as a result of screening. Our results suggest that the International criteria have the lowest false-positive rate of athlete-specific ECG criteria, and thus, it is the preferred method for preparticipation ECG screening in NCAA athletes.
（1）分析美国大学生体育协会（NCAA）第一分区运动员连续5年进行的包括12导联心电图（ECG）在内的参赛前心脏筛查结果；（2）评估三种心电图筛查标准中心电图筛查异常率和假阳性率。
回顾性图表审查。
NCAA第一分区大学。
1686名参加参赛前检查（包括12导联静息心电图）的一年级运动员。
在研究期结束时，使用西雅图标准、改良标准和国际标准对所有心电图进行回顾性审查。
（1）筛查发现的病理性心脏疾病患病率；（2）按标准划分的心电图筛查异常数量。
发现3名运动员（0.2%）患有与心源性猝死相关的疾病。使用西雅图标准、改良标准和国际标准对心电图进行回顾性审查，发现异常心电图率分别为3.0%、2.1%和1.8%。与西雅图标准相比，国际标准[优势比（OR），0.58；P = 0.02]显示假阳性率较低。西雅图标准与改良标准（OR，0.68；P = 0.09）或国际标准与改良标准（OR，0.85；P = 0.5）之间的假阳性率无显著差异。
该人群中严重心脏病理情况的发生率较低，且没有运动员因筛查而被永久禁止参赛。我们的结果表明，国际标准在特定运动员心电图标准中的假阳性率最低，因此是NCAA运动员参赛前心电图筛查的首选方法。
