676 MEP160 – Investigating the additional benefits of including echocardiography in cardiac screening programmes

AbstractBackground Echocardiography is included in some but not all cardiac screening pre-participation protocols across the world, whilst ECG is standard in almost all of them. Echocardiography can detection structural cardiac abnormalities that ECG cannot, however it may not be cost efficient in a screening programmeObjective To identify whether including Echocardiography in pre-participation cardiac screening programmes has any additional benefit alongside ECG in terms of identifying cardiac abnormalities which can predispose athletes to Sudden Cardiac Death.Setting Hamden Sports clinic, Scotland.Participants Data was collected using a convenience sample of 326 cardiac screening files from varying dates in 2022. The final sample included 326 male football players from Scottish Premiership teams (mean age 21.8 ± 5.8 years) with both ECG and ECHO results.Design A retrospective cohort study design was used. Data was gathered between September 2023 and November 2023. Statistical analysis was used to detect differences in quantity and type of cardiac abnormality detected by ECG compared to ECHO.Interventions & Outcome measurements The use of Echocardiography (independent variable) in cardiac screening had an effect on cardiac abnormality detection (dependant variable). Left Ventricular Hypertrophy (LVH) was analysed separately from all other cardiac abnormalities.Results No significant difference (p>0.05) was found between ECHO and ECG in terms of the quantity of cardiac abnormalities detected. This applied to all cardiac abnormalities and LVH specifically. For LVH, ECHO showed low sensitivity (0.46) and moderate specificity (0.60) of detection when compared to ECG. For all cardiac abnormalities, ECHO showed low sensitivity (0.13) and high specificity (0.87) of detection when compared to ECG. Conclusions ECHO showed no additional benefit alongside ECG regarding the quantity of cardiac abnormalities detected in a cardiac screening programme. However, sensitivity calculations suggested that the two modes detect different abnormalities in some cases, and can often disagree.View this table:View inline View popup Download powerpoint Abstract 676 Table 1 Odds ratios for quantity of abnormality detection by ECG and ECHOView this table:View inline View popup Download powerpoint Abstract 676 Table 2 Definitions of LVH and 'abnormal' ECG and ECHO results