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Does one size fit all for ECG-based risk stratification in athletes?

ESC Congress News 2018 - Munich, Germany

There is no doubt that regular exercise is beneficial to health and has a positive impact on cardiovascular risk factors; however, in rare cases, exercise can result in sudden cardiac death (SCD).

Electrocardiography
Cardiovascular Risk Assessment
Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
Risk Factors and Prevention
Sports Cardiology


The cause of SCD in young athletes (aged 35 years and younger) is mostly inherited cardiac conditions, which can be identified by screening because of complaints or by an ECG.1,2 Recommendations advocate for ECG

screening of younger competitive athletes to prevent SCD,2 but these recommendations have not been tested in older or ‘master’ athletes (aged over 35 years).

Today, Doctor Nicole M. Panhuyzen- Goedkoop (Amsterdam University Medical Centers and Radboud University Medical Center, Nijmegen, Netherlands) will present the results of a study that evaluated whether criteria-based ECG recommendations proposed for young athletes could also be used in master athletes (Abstract 81104). The study used data from 494 master athletes with abnormal screening results that triggered referral for cardiac evaluation.

Dr. Panhuyzen-Goedkoop’s group retrospectively analysed the ECG results for these athletes according to ESC,3 Seattle4 and International5 criteria to define which

criteria were the most appropriate for detecting cardiovascular conditions that are associated with an increased risk of SCD (HRCC). The application of the three criteria resulted in the detection of different conditions: for example, ESC and Seattle criteria most commonly detected atrial enlargement (22%) and left ventricular hypertrophy (20%), while the International criteria most commonly detected ST-segment depression (13%) and T-wave inversion (12%). Cardiovascular conditions were diagnosed in more than half (57%)

of the referred athletes, with 11% having HRCC. SCD occurred in three athletes. Of the criteria tested, the ESC criteria were found to be the most sensitive (67%) and the International criteria were the most specific (47%). The proportion of false-positive and false-negative results with the International criteria was 9.9% and 39.7%, compared with 24.3% and 19.0% with the ESC criteria and 16.2% and 30.4% with the Seattle criteria.  Dr. Panhuyzen-Goedkoop will conclude that criteria based on ECG findings intended for use in young athletes are also appropriate for master athletes over the age of 35.

  1. Wasfy MM, et al. Methodist Debakey Cardiovasc J 2016;12:76–80.
  2. Panhuyzen-Goedkoop NM, et Neth Heart J 2018;26:127–132.
  3. Corrado D, et al. Eur Heart J 2005;26:516–524.
  4. Drezner JA, et al. Br J Sports Med 2013;47:122–124.
  5. Sharma S, et Eur Heart J 2018;39:1466–1480.

 

 

Click here to read other scientific highlights in the ESC Congress news.

Notes to editor

About the European Society of Cardiology

The European Society of Cardiology brings together healthcare professionals from more than 150 countries, working to advance cardiovascular medicine and help people lead longer, healthier lives.

About ESC Congress 2018

ESC Congress is the world’s largest and most influential cardiovascular event contributing to global awareness of the latest clinical trials and breakthrough discoveries. ESC Congress 2018 takes place 25 to 29 August at the Messe München in Munich, Germany. Explore the scientific programme