Key result
Clinical signs and symptoms could not reliably predict electrocardiogram changes, suggesting that ECG should be a routine part of pre-participation examinations for elite athletes.
Cross-Sectional (n=388)
Routine ECG screening in elite athletes detects electrical variations that are not predicted by clinical signs and symptoms, supporting its inclusion in pre-participation examinations.
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Observational prevalence data in elite Asian athletes; leaves open whether adding ECG to PPE prevents sudden cardiac death.
BACKGROUND: Athletes' health is an important issue and for promoting it, pre-participation examination (PPE) is widely performed by responsible bodies around the world. OBJECTIVES: This study was to determine prevalence of cardiovascular disorders among athletes participating in the Asian games and answering the question whether the electrocardiogram (ECG) is a necessary part of pre-participation examination (PPE) for prevention of sudden cardiac death. MATERIALS AND METHODS: All athletes participated at Asian games came to sports medicine federation for a PPE including a comprehensive questionnaire, physical examination and ECG. In this retrospective study all profiles of 338 athletes have been studied as well as their electrocardiograms. Multiple logistic regressions as well as Firth's bias reduction were used with R statistical software and SPSS. For predicting the changes in ECG, receiver operating characteristic (ROC) curve has done. RESULTS: Among 388 athletes, 80 (20.6%) were female and 308 (79.4%) male with mean age of 23.2 + 8 years. Nine athletes (2.3%) were smokers, 28 of them (7.2%) experienced chest pain and discomfort, 45 of them (13.3%) had palpitations and 28 (7.2%) had history of anemia. Study of their electrocardiograms showed that long Q-T interval was not seen for anyone, but evidence of left ventricular hypertrophy was seen in 12 (3.1%), inverted T wave in 6 (1.5%), and right bundle branch block in 45 (13.3%). CONCLUSIONS: PPE provides very important information of athletes' health. This study has shown that there was not any significant relation between current examination and electrocardiogram changes but regarding the ECG changes we recommend it as a routine part of PPE.
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Salehi et al. (2016) conducted a cross-sectional in Cardiovascular screening in elite athletes (n=388). Clinical signs and symptoms was evaluated on Prediction of ECG changes based on clinical signs and symptoms (Area under the ROC curve) (AUC 0.505, 95% CI 0.450-0.560, p=0.863). Clinical signs and symptoms could not reliably predict electrocardiogram changes, suggesting that ECG should be a routine part of pre-participation examinations for elite athletes.
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