Key result
Return-to-play via shared decision making in elite GHD athletes is linked to ~1% exercise-related events.
Its licence doesn't allow us to show a copy here.
Why the study?
Athletes with genetic heart diseases (GHDs) predisposing to sudden cardiac death have historically been restricted from competitive sports, but emerging data on shared decision-making suggest lower cardiac event rates than previously described.
Cohort (n=76)
Yes
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“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.'”
“This initial data set offers a story of hope and encouragement. With shared decision-making and appropriate risk stratification by an expert, we expect anybody of any age can live and thrive despite their diagnosis.”
“The evidence that we're presenting counters the idea that this is unacceptable risk-taking behavior. We're not suggesting this is the only way to protect athletes. We're still advocating for continued use of hands-only CPR and AEDs to add another layer of protection.”
May support safer return-to-play protocols in athletes with genetic heart conditions; hypothesis-generating and requires prospective confirmation before practice change.
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.
No takes yet. Share an insight, caveat, or question.
Martinez et al. (2023) 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.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: