Cardiovascular Clinical Academic Group, St Georges, University of London, United Kingdom.
Department of Cardiology, Glenfield Hospital, United Kingdom.
J Sci Med Sport. 2022 Apr;25(4):287-292. doi: 10.1016/j.jsams.2021.12.001. Epub 2021 Dec 8.
We assessed the diagnostic yield and costs of an electrocardiogram-based national screening programme in elite cricket players and the incremental value of transthoracic echocardiography and periodic evaluation.
Cross-sectional study.
Between 2008 and 2019, 1208 cricketers underwent screening with a health questionnaire, 12-lead electrocardiogram and cardiology consultation. Athletes with concerning findings underwent on-site transthoracic echocardiography and further investigations as necessary. In addition, despite a normal health questionnaire and electrocardiogram, 342 (28.3%) athletes had a transthoracic echocardiogram and 493 (40.8%) underwent repeat evaluations.
After initial evaluation, 47 (3.9%) athletes underwent on-site transthoracic echocardiography of whom 35 (2.8%) were referred for further evaluation. Four athletes (0.3%) were diagnosed with major cardiac conditions; hypertrophic cardiomyopathy (n = 1), arrhythmogenic cardiomyopathy (n = 1) and Wolff-Parkinson-White pattern (n = 2). Two athletes were identified with minor valvular abnormalities. Repeat evaluation of 493 athletes identified hypertrophic cardiomyopathy in a 22-year-old athlete, two years after his initial normal screening. During a follow-up of 5.8 ± 2.9 years no additional diagnoses or adverse cardiac events were reported. The cost of the electrocardiogram-based programme was £127,844, translating to £106 per athlete and £25,569 per major cardiac condition identified.Routine transthoracic echocardiography in 342 athletes identified two athletes with major cardiac conditions (bicuspid aortic valve with severe aortopathy and aortic regurgitation and an atrial septal defect associated with right ventricular volume overload) and 10 athletes with minor abnormalities.
An electrocardiogram-based national screening programme identified a major cardiac condition in 0.3% of athletes. Routine transthoracic echocardiography and periodic evaluation increased the diagnostic yield to 0.6%, at an incremental cost.
评估基于心电图的国家级精英板球运动员筛查计划的诊断收益和成本，以及经胸超声心动图和定期评估的附加价值。
横断面研究。
2008 年至 2019 年，1208 名板球运动员接受了健康问卷、12 导联心电图和心脏病学咨询的筛查。有可疑发现的运动员在现场进行经胸超声心动图检查，并根据需要进行进一步检查。此外，尽管健康问卷和心电图正常，仍有 342 名（28.3%）运动员进行了经胸超声心动图检查，493 名（40.8%）运动员进行了重复评估。
初次评估后，47 名（3.9%）运动员进行了现场经胸超声心动图检查，其中 35 名（2.8%）被转介进行进一步评估。4 名运动员（0.3%）被诊断出患有重大心脏疾病；肥厚型心肌病（n=1）、致心律失常性右室心肌病（n=1）和 Wolff-Parkinson-White 模式（n=2）。两名运动员被发现存在轻微的瓣膜异常。对 493 名运动员进行重复评估，发现一名 22 岁的运动员在初次正常筛查两年后患有肥厚型心肌病。在 5.8±2.9 年的随访中，没有报告其他诊断或不良心脏事件。基于心电图的方案成本为 127844 英镑，每名运动员为 106 英镑，每发现一种重大心脏疾病的成本为 25569 英镑。对 342 名运动员进行常规经胸超声心动图检查，发现 2 名运动员存在重大心脏疾病（二叶式主动脉瓣伴严重主动脉病变和主动脉瓣反流，以及房间隔缺损伴右心室容量超负荷）和 10 名运动员存在轻微异常。
基于心电图的国家级筛查计划在 0.3%的运动员中发现了一种重大心脏疾病。常规经胸超声心动图和定期评估可将诊断收益提高到 0.6%，但成本增加。
