Author + information
- Paolo Angelini,
- Nishant R. Shah,
- Carlo E. Uribe,
- Benjamin Y. Cheong,
- Veronica Lenge,
- J.A. Lopez,
- Christine E. Lawless,
- Anthony H. Masso and
- James T. Willerson
United States guidelines for preparticipation screening of competitive athletes estimate a combined prevalence of 0.3% for high–risk cardiovascular conditions (hr–CVC) thought to be associated with sudden cardiac death (SCD). However, there is minimal prospective data regarding the true prevalence of these conditions.
6th–8th graders (age range 11–15 years) attending schools in the Houston Independent School District and their parents were asked to give consent to undergo screening for hr–CVC with three components: a medical history questionnaire, a resting 16–lead electrocardiogram (ECG), and a simplified cardiac magnetic resonance imaging (CMR) protocol (15–25 minute acquisition time; no contrast, sedation or intravenous access required). ECG and CMR data were interpreted independently by expert reviewers using established pediatric ECG and CMR criteria. A third expert reviewer made the final determination regarding the presence of hr–CVC.
1,836 subjects have thus far completed the full screening protocol, out of a planned 10,000 subjects, and the results from this preliminary cohort are reported here. The origin and proximal course of both coronary arteries, as well left ventricular structure and function, were adequately assessed by CMR in over 99% of subjects. 24 subjects (1.3%) were identified as having hr–CVC. 13 subjects (0.7%) had anomalous coronary artery from the opposite sinus with an intramural course (ACAOS), including 11 with right ACAOS and 2 with left ACAOS. 4 subjects (0.2%) had hypertrophic cardiomyopathy, 2 (0.1%) had dilated cardiomyopathy, 2 (0.1%) had prolonged QTc, and 3 (0.2%) had Wolff–Parkinson–White syndrome. Additionally, by CMR criteria, 80 subjects (4.4%) had isolated left ventricular non–compaction, a condition with unclear risk for SCD.
The initial results of this large, prospective study utilizing our novel screening protocol demonstrate that the prevalence of hr–CVC is 1.3%, more than four times the previously estimated prevalence. This difference has important implications for the cost–effectiveness analyses regarding inclusion of noninvasive diagnostic testing in preparticipation screening.
South, Room 102
Sunday, March 10, 2013, 11:30 a.m.–11:45 a.m.
Session Title: Evaluating the Athlete's Heart: Emerging Science
Abstract Category: 30. Sports and Exercise Cardiology: Sports Medicine
Presentation Number: 930–6
- 2013 American College of Cardiology Foundation