595 EP102 – Advancements in pre-participation evaluation (PPE): ensuring cardiovascular health in athletes

Background In the realm of elite athletics, rigorous health assessment is imperative. The Pre-participation Evaluation (PPE) has become an essential screening tool for athletes. Objective To underscore the importance of the refined PPE in safeguarding athletes' cardiovascular health and advocate for a standardized approach across Europe. Design A comprehensive review of European guidelines and publications regarding PPE, with a primary focus on protocols incorporating ECG screening. Setting European athletic organizations and competitions, including events leading up to and including the Olympics. Patients (or Participants) Athletes from various European countries participating in elite sports. Interventions (or Assessment of Risk Factors) The criticality of ECG in distinguishing physiologically adaptive cardiac changes from pathological entities was scrutinized. Evaluations encompassed determinants of functional capacity, neuromuscular assessments, psychological appraisals, and the intricate metrics derived from the cardio-pulmonary exercise test (CPET). Main Outcome Measurements Determination of athletes' eligibility for sports based on medical evaluations, with a focus on cardiovascular health. Results PPE categorizes athletes into: medically eligible, those necessitating supplementary assessments, or those contraindicated for competitive engagement. Noteworthy challenges persist within European domains due to heterogeneity in Sport and Exercise Medicine (SEM) recognition and disparities in ECG interpretative strategies. Recommendations: It would be beneficial for the PPE to be consistently applied to all athletes. Emphasizing a standardized, digital evaluative platform across European territories might lead to more consistent evaluations. Such a system could also provide a valuable repository for performance and health-oriented research. Conclusion A unified and enhanced PPE, particularly focusing on cardiovascular health, is vital in elite sports, guaranteeing athletes not only reach their peak performance but also maintain optimal health standards.