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Electrocardiographic Screening in National Collegiate Athletic Association Athletes.
- Source :
-
The American journal of cardiology [Am J Cardiol] 2016 Sep 01; Vol. 118 (5), pp. 754-9. Date of Electronic Publication: 2016 Jun 14. - Publication Year :
- 2016
-
Abstract
- The most effective protocol for cardiovascular screening of competitive athletes remains highly controversial. This study was a prospective, multicenter trial of cardiovascular screening at 35 National Collegiate Athletic Association institutions. Screening included a standardized history and physical examination (PE) as recommended by the American Heart Association and a 12-lead electrocardiogram (ECG) at rest. Centralized electrocardiographic interpretation was provided using the Seattle criteria. Athletes with screening abnormalities underwent additional evaluation directed by the host institution medical team. Primary outcomes included the proportion of total and false-positive screens; the sensitivity, specificity, and positive predictive value of history, PE, and ECG; and the prevalence of serious cardiovascular disorders associated with severe morbidity or sudden cardiac death. From August 2012 to June 2014, 5,258 athletes from 17 intercollegiate sports were screened: 55% men (mean age 20.1 years), 73% Caucasian, 16% African-American, and 11% other/mixed race. At least 1 positive cardiac symptom or family history response was reported by 1,750 athletes (33.3%). PE was abnormal in 108 athletes (2.1%), and electrocardiographic abnormalities were present in 192 athletes (3.7%). Thirteen athletes (0.25%) were identified with serious cardiac conditions including hypertrophic cardiomyopathy (1), large atrial septal defect with right ventricular dilation (1), and ventricular pre-excitation (11). The false-positive rate for history was 33.3%, PE 2.0%, and ECG 3.4%. The sensitivity/specificity/positive predictive value for history was 15.4%/66.9%/0.1%, PE 7.7%/98.2%/0.9%, and ECG 100%/96.6%/6.8%. In conclusion, electrocardiographic screening in National Collegiate Athletic Association athletes has a low false-positive rate and provides superior accuracy compared with a standardized history and PE to detect athletes with potentially dangerous cardiovascular conditions.<br /> (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Adult
Cardiomyopathy, Hypertrophic diagnosis
Ethnicity
Female
Heart Diseases epidemiology
Heart Septal Defects, Atrial diagnosis
Humans
Male
Medical History Taking
Predictive Value of Tests
Prospective Studies
Sensitivity and Specificity
United States epidemiology
Universities
Athletes statistics & numerical data
Electrocardiography
Heart Diseases diagnosis
Mass Screening statistics & numerical data
Physical Examination
Sports
Students statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1913
- Volume :
- 118
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- The American journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 27496294
- Full Text :
- https://doi.org/10.1016/j.amjcard.2016.06.004