Department of Molecular Pharmacology and Experimental Therapeutics (Windland Smith Rice Sudden Death Genomics Laboratory), Mayo Clinic, Rochester, Minnesota, USA.
Department of Molecular Pharmacology and Experimental Therapeutics (Windland Smith Rice Sudden Death Genomics Laboratory), Mayo Clinic, Rochester, Minnesota, USA; Department of Cardiovascular Medicine (Division of Heart Rhythm Services, Windland Smith Rice Genetic Heart Rhythm Clinic), Mayo Clinic, Rochester, Minnesota, USA; Department of Pediatric and Adolescent Medicine (Division of Pediatric Cardiology), Mayo Clinic, Rochester, Minnesota, USA.
J Am Coll Cardiol. 2023 Aug 22;82(8):661-670. doi: 10.1016/j.jacc.2023.05.059.
People diagnosed with genetic heart diseases (GHDs) associated with sudden cardiac death (SCD) have historically been restricted from competitive sports. Recent data documenting return-to-play (RTP) experiences following shared decision making (SDM) suggest that cardiac event rates for athletes with a GHD are lower than previously described, thereby suggesting an opportunity to reconsider this paradigm.
The purpose of this study was to evaluate clinical outcomes among National Collegiate Athletic Association Division I university and professional athletes diagnosed with a GHD.
A multicenter retrospective analysis was performed to examine demographics, clinical characteristics, RTP outcomes, and cardiac events among elite athletes with a GHD.
A total of 76 elite (66%, Division I, 34% professional) athletes (age 19.9 ± 5 years, 28% women) diagnosed with a GHD (hypertrophic cardiomyopathy [53%], long QT syndrome, long QT syndrome [26%]) comprise this cohort. Most athletes were asymptomatic (48 of 76, 63%) before diagnosis and had their GHD detected during routine preparticipation cardiovascular screening. Most athletes (55 of 76, 72%) were initially disqualified from their sport but subsequently opted for unrestricted RTP after comprehensive clinical evaluation and SDM. To date, (mean follow-up 7 ± 6 years), only 1 exercise-related (1.3%) and 2 nonexercise-related GHD-associated adverse cardiac events occurred. There have been no fatalities during follow-up.
This is the first study describing the experience of athletes with a known SCD-predisposing GHD who are competing at the elite level. After careful evaluation, risk stratification, and tailoring of their GHD therapy, RTP following SDM appears associated with low, nonfatal events rates at elite levels of sport.
患有与心源性猝死（SCD）相关的遗传性心脏病（GHD）的患者历来被限制参加竞技体育。最近有数据记录了在共同决策（SDM）后运动员重返赛场（RTP）的经历，这表明患有 GHD 的运动员的心脏事件发生率低于先前描述的水平，这表明有机会重新考虑这一模式。
本研究旨在评估患有 GHD 的美国大学体育协会（NCAA）一级大学和职业运动员的临床结局。
进行了一项多中心回顾性分析，以检查患有 GHD 的精英运动员的人口统计学、临床特征、RTP 结果和心脏事件。
共有 76 名精英运动员（66%为一级运动员，34%为职业运动员）（年龄 19.9 ± 5 岁，28%为女性）被诊断患有 GHD（肥厚型心肌病[53%]、长 QT 综合征、长 QT 综合征[26%]）。大多数运动员在诊断前无症状（76 例中的 48 例，63%），他们的 GHD 是在常规参加前心血管筛查中发现的。大多数运动员（76 例中的 55 例，72%）最初被禁止参加运动，但在经过全面临床评估和 SDM 后，他们选择了不受限制的 RTP。迄今为止（平均随访 7 ± 6 年），仅发生了 1 例与运动相关（1.3%）和 2 例与运动无关的 GHD 相关不良心脏事件。随访期间没有死亡。
这是第一项描述患有已知易患 SCD 的 GHD 且正在精英水平比赛的运动员的经验的研究。在仔细评估、风险分层和调整他们的 GHD 治疗后，SDM 后 RTP 似乎与精英运动水平的低、非致命性事件率相关。
