Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
PLoS One. 2021 Apr 9;16(4):e0249923. doi: 10.1371/journal.pone.0249923. eCollection 2021.
The significance of cardiology screening of referees is not well established. Cardiovascular risk factors and diseases were examined in asymptomatic Hungarian elite handball referees undergoing extended screening: personal/family history, physical examination, 12-lead ECG, laboratory tests, body-composition analysis, echocardiography, and cardiopulmonary exercise testing. Holter-ECG (n = 8), blood pressure monitorization (n = 10), cardiac magnetic resonance imaging (CMR; n = 27) and computer tomography (CCT; n = 4) were also carried out if needed. We examined 100 referees (age: 29.6±7.9years, male: 64, training: 4.3±2.0 hours/week), cardiovascular risk factors were: positive medical history: 24%, overweight: 10%, obesity: 3%, dyslipidaemia: 41%. Elevated resting blood pressure was measured in 38%. Stress-ECG was positive due to ECG-changes in 16%, due to elevated exercise blood pressure in 8%. Echocardiography and/or CMR identified abnormalities in 19%. A significant number of premature ventricular contractions was found on the Holter-ECG in two cases. The CCT showed myocardial bridge or coronary plaques in one-one case. We recommended lifestyle changes in 58%, new/modified antihypertensive or lipid-lowering therapy in 5%, iron-supplementation in 22%. By our results, a high percentage of elite Hungarian handball referees had cardiovascular risk factors or diseases, which, combined with physical and psychological stress, could increase the possibility of cardiovascular events. Our study draws attention to the importance of cardiac screening in elite handball referees.
心脏病学筛查对裁判员的意义尚未得到充分证实。我们对正在接受扩展筛查的无症状匈牙利精英手球裁判员进行了心血管危险因素和疾病检查：个人/家族病史、体格检查、12 导联心电图、实验室检查、身体成分分析、超声心动图和心肺运动测试。如果需要，还进行了动态心电图（n=8）、血压监测（n=10）、心脏磁共振成像（CMR；n=27）和计算机断层扫描（CCT；n=4）。我们检查了 100 名裁判员（年龄：29.6±7.9 岁，男性：64 名，训练：4.3±2.0 小时/周），心血管危险因素包括：阳性病史：24%，超重：10%，肥胖：3%，血脂异常：41%。38%的人静息血压升高。16%的人因心电图改变，8%的人因运动血压升高而出现应激心电图阳性。超声心动图和/或 CMR 发现 19%的人存在异常。两名患者在动态心电图上发现大量室性早搏。一例 CCT 显示心肌桥或冠状动脉斑块。我们建议 58%的人改变生活方式，5%的人开始/调整抗高血压或降脂治疗，22%的人补充铁剂。根据我们的结果，很大一部分匈牙利精英手球裁判员存在心血管危险因素或疾病，再加上身体和心理压力，可能会增加心血管事件的可能性。我们的研究提醒人们注意对精英手球裁判员进行心脏筛查的重要性。
