Return-to-play following shared decision making among elite athletes with genetic heart diseases was associated with a 1.3% rate of exercise-related adverse cardiac events over a mean of 7 years.
Cohort (n=76)
Yes
BACKGROUND People diagnosed with genetic heart diseases (GHDs) associated with sudden cardiac death (SCD) have historically been restricted from competitive sports. Recent data documenting return-to-play (RTP) experiences following shared decision making (SDM) suggest that cardiac event rates for athletes with a GHD are lower than previously described, thereby suggesting an opportunity to reconsider this paradigm. OBJECTIVES The purpose of this study was to evaluate clinical outcomes among National Collegiate Athletic Association Division I university and professional athletes diagnosed with a GHD. METHODS A multicenter retrospective analysis was performed to examine demographics, clinical characteristics, RTP outcomes, and cardiac events among elite athletes with a GHD. RESULTS A total of 76 elite (66%, Division I, 34% professional) athletes (age 19.9 ± 5 years, 28% women) diagnosed with a GHD (hypertrophic cardiomyopathy 53%, long QT syndrome, long QT syndrome 26%) comprise this cohort. Most athletes were asymptomatic (48 of 76, 63%) before diagnosis and had their GHD detected during routine preparticipation cardiovascular screening. Most athletes (55 of 76, 72%) were initially disqualified from their sport but subsequently opted for unrestricted RTP after comprehensive clinical evaluation and SDM. To date, (mean follow-up 7 ± 6 years), only 1 exercise-related (1.3%) and 2 nonexercise-related GHD-associated adverse cardiac events occurred. There have been no fatalities during follow-up. CONCLUSIONS This is the first study describing the experience of athletes with a known SCD-predisposing GHD who are competing at the elite level. After careful evaluation, risk stratification, and tailoring of their GHD therapy, RTP following SDM appears associated with low, nonfatal events rates at elite levels of sport.
“The guidelines used to be that unless your heart is perfect, you can't do anything, but these results suggest that we should change that message. [Clinicians] should be encouraging most of our patients to exercise. It's not 'can you play or not,' but it's 'let's figure out an exercise plan for you.'”
Martinez et al. (Tue,) conducted a cohort in Genetic heart diseases (GHDs) (n=76). Return-to-play (RTP) following shared decision making was evaluated on Exercise-related GHD-associated adverse cardiac events. Return-to-play following shared decision making among elite athletes with genetic heart diseases was associated with a 1.3% rate of exercise-related adverse cardiac events over a mean of 7 years.