The importance of electrocardiogram in the sports-medical visit to reduce the risk of sudden death;L'importanza dell'elettrocardiogramma nella visita medico-sportiva per ridurre il rischio di morte improvvisa

Giornale Italiano di Cardiologia

Volumn 12, Issue 11, 2011, Pages 697-706

  Corrado, Domenico ^a   Migliore, Federico ^a   Zorzi, Alessandro ^a   Siciliano, Mariachiara ^a   Basso, Cristina ^a   Schiavon, Maurizio ^b   Thiene, Gaetano ^a  

^a UNIVERSITY OF PADOVA   (Italy)

^b UNIVERSITY HOSPITAL OF PADOVA   (Italy)

Author keywords

Athletes; Cardiomyopathies; Pre participation screening; Sport; Sudden cardiac death

Indexed keywords

ATHLETE; CARDIOMYOPATHY; ELECTROCARDIOGRAM; HEALTH CARE COST; HEALTH CARE SYSTEM; HEART ARRHYTHMIA; HEART DEATH; HUMAN; LEISURE; MORTALITY; REVIEW; RISK ASSESSMENT; SCREENING TEST; SENSITIVITY AND SPECIFICITY; SPORTS MEDICINE; SUDDEN DEATH;

DEATH, SUDDEN, CARDIAC; DECISION TREES; ELECTROCARDIOGRAPHY; HUMANS; SENSITIVITY AND SPECIFICITY; SPORTS;

EID: 82755191749     PISSN: 18276806     EISSN: None     Source Type: Journal    
DOI: 10.1714/966.10541     Document Type: Review

References (52)

1. Fletcher GF, Balady G, Blair SN, et al. Statement on exercise: benefits and recommendations for physical activity programs for all Americans. A statement for health professionals by the Committee on Exercise and Cardiac Rehabilitation of the Council on Clinical Cardiology, American Heart Association. Circulation 1996;94:857-62. (Pubitemid 26289247)
2. Thompson PD, Buchner D, Pina IL, et al. Exercise and physical activity in the prevention and treatment of atherosclerotic cardiovascular disease: a statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity). Circulation 2003;107:3109-16. (Pubitemid 36758987)
3. Curfman GD. The health benefits of exercise. A critical reappraisal. N Engl J Med 1993;328:574-6. (Pubitemid 23053836)
4. Curfman GD. Is exercise beneficial - or hazardous - to your heart? N Engl J Med 1993;239:1730-1. (Pubitemid 23346926)
5. Maron BJ. The paradox of exercise. N Engl J Med 2000;343:1409-11.
6. Corrado D, Migliore F, Basso C, Thiene G. Exercise and the risk of sudden cardiac death. Herz 2006;31:553-8. (Pubitemid 44579728)
7. Thompson PD, Funk EJ, Carleton RA, Sturner WQ. Incidence of death during jogging in Rhode Island from 1975 through 1980. JAMA 1982;247:2535-8. (Pubitemid 12155952)
8. Siscovick DS, Weiss NS, Fletcher RH, Lasky T. The incidence of primary cardiac arrest during vigorous exercise. N Engl J Med 1984;311:874-7. (Pubitemid 14041544)
9. Corrado D, Basso C, Thiene G. Essay: Sudden death in young athletes. Lancet 2005;366(Suppl 1):S47-S48. (Pubitemid 41790668)
10. Corrado D, Thiene G, Nava A, Rossi L, Pennelli N. Sudden death in young competitive athletes: clinicopathologic correlations in 22 cases. Am J Med 1990;89:588-96. (Pubitemid 20384315)
11. Maron BJ. Sudden death in young athletes. N Engl J Med 2003;349:1064-75. (Pubitemid 37098275)
12. Corrado D, Basso C, Rizzoli G, Schiavon M, Thiene G. Does sports activity enhance the risk of sudden death in adolescents and young adults? J Am Coll Cardiol 2003;42:1959-63. (Pubitemid 37485572)
13. Corrado D, Basso C, Schiavon M, Thiene G. Screening for hypertrophic cardiomyopathy in young athletes. N Engl J Med 1998;339:364-9. Questo studio dimostra come il protocollo di screening italiano, essenzialmente basato sull'ECG, permette di identificare i giovani atleti affetti da cardiomiopatia ipertrofica con una sensibilitàparagonabile a quella dello screening ecocardiografico. Insoddisfacente risulta invece la sensibilità (del 77% inferiore) dello screening raccomandato dall'American Heart Association, esclusivamente basato su anamnesi ed esame obiettivo (senza ECG).
14. Corrado D, Basso C, Pavei A, Michieli P, Schiavon M, Thiene G. Trends in sudden cardiovascular death in young competitive athletes after implementation of a preparticipation screening program. JAMA 2006;296:1593-601. Questo articolo dimostra come l'introduzione per legge dello screening ECG nel 1982 in Italia, si è tradotta in una sostanziale riduzione dell'incidenza di morte improvvisa cardiovascolare dei giovani atleti. La riduzione della mortalitàrisulta legata al minor numero di decessi per cardiomiopatie identificate grazie all'ECG.
15. Corrado D, Pelliccia A, Bjornstad HH, et al. Cardiovascular pre-participation screening of young competitive athletes for prevention of sudden death: proposal for a common European protocol. Consensus Statement of the Study Group of Sport Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology. Eur Heart J 2005;26:516-24. Proposta della sezione "Sports Cardiology"della Società Europea di Cardiologia di adottare a livello europeo l'attuale protocollo della visita medicosportiva per l'idoneità sportiva agonistica (essenzialmente basato sull'ECG) in vigore in Italia per legge dal 1982, che ha permesso di ridurre significativamente la mortalità nell'atleta.
16. Corrado D, Basso C, Schiavon M, Pelliccia A, Thiene G. Pre-participation screening of young competitive athletes for prevention of sudden cardiac death. J Am Coll Cardiol 2008;52:1981-9.
17. Corrado D, Schmied C, Basso C, et al. Risk of sports: do we need a pre-participation screening for competitive and leisure athletes? Eur Heart J 2011;32:934-44.
18. Maron BJ, Thompson PD, Ackerman MJ, et al. Recommendations and considerations related to preparticipation screening for cardiovascular abnormalities in competitive athletes: 2007 update: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism: endorsed by the American College of Cardiology Foundation. Circulation 2007;115:1643-55. (Pubitemid 46648650)
19. Oswald D, Dvorak J, Corrado D, et al. Sudden cardiovascular death in sport. Lausanne recommendations: preparticipation cardiovascular screening. http://www.olympic.org/Documents/Reports/EN/enreport826.pdf.
20. Myerburg RJ, Vetter VL. Electrocardiograms should be included in preparticipation screening of athletes. Circulation 2007;116:2616-26.
21. Wilson JMG, Jungner G. Principles and practice of screening for diseases. Geneva: World Health Organization, 1968.
22. Thompson PD, Franklin BA, Balady GJ, et al. Exercise and acute cardiovascular events placing the risks into perspective. Circulation 2007;115:2358-68.
23. Van Camp SP, Bloor CM, Mueller FO, Cantu RC, Olson HG. Non-traumatic sports death in high school and college athletes. Med Sci Sports Exerc 1995;27:641-7.
24. Maron BJ, Doerer JJ, Haas TS, Tierney DM, Mueller FO. Sudden deaths in young competitive athletes: analysis of 1866 deaths in the United States, 1980-2006. Circulation 2009;119:1085-92.
25. Maron BJ, Haas TS, Doerer JJ, Thompson PD, James HS. Comparison of US and Italian experiences with sudden cardiac deaths in young competitive athletes and implications for preparticipation screening strategies. Am J Cardiol 2009;104:276-80.
26. Corrado D, Basso C, Thiene G. Comparison of United States and Italian experiences with sudden cardiac deaths in young competitive athletes: are the athletic populations comparable? Am J Cardiol 2010;105:421-2.
27. Eckart RE, Scoville SL, Campbell CL et al. Sudden death in young adults: a 25-year review of autopsies in military recruits. Ann Intern Med 2004;141:829-34. (Pubitemid 39601175)
28. Atkins DL, Everson-Stewart S, Sears GK, et al.; Resuscitation Outcomes Consortium Investigators. Epidemiology and outcomes from out-of-hospital cardiac arrest in children: the Resuscitation Outcomes Consortium Epistry-Cardiac Arrest. Circulation 2009;119:1484-91.
29. Chugh SS, Reinier K, Balaji S, et al. Population-based analysis of sudden death in children: the Oregon Sudden Unexpected Death Study. Heart Rhythm 2009;6:1618-22.
30. Harmon KG, Asif IM, Klossner D, Drezner JA. Incidence of sudden cardiac death in national collegiate athletic association athletes. Circulation 2011;123:1594-600
31. Maron BJ, Roberts WC, McAllister MA, et al. Sudden death in young athletes. Circulation 1980;62:218-29. (Pubitemid 10035639)
32. Burke AP, Farb A, Virmani R, et al. Sports-related and non-sports related sudden cardiac death in young adults. Am Heart J 1991;121:568-75.
33. Basso C, Carturan E, Pilichou K, Rizzo S, Corrado D, Thiene G. Sudden cardiac death with normal heart: molecular autopsy. Cardiovasc Pathol 2010;19:321-5.
34. Maron BJ, Gohman TE, Kyle SB, Estes NA, Link MS. Clinical profile and spectrum of commotio cordis. JAMA 2002;287:1142-6. (Pubitemid 34252083)
35. Ekker Solberg E, Embra BI, Borjesson M, Herlitz J, Corrado D. Commotio cordis - under-recognized in Europe? A case report and review. Eur J Cardiovasc Prev Rehabil 2011 Feb 9 [Epub ahead of print].
36. Maron BJ, Gardin JM, Flack JM, Gidding SS, Kurosaki TT, Bild DE. Prevalence of hypertrophic cardiomyopathy in a general population of young adults. Echocardiographic analysis of 4111 subjects in the CARDIA Study. Coronary Artery Risk Development in (Young) Adults. Circulation 1995;92:785-9.
37. Foote CB, Michaud GF. The athlete's electrocardiogram: distinguishing normal from abnormal. In: Estes NA, Salem DN, Wang PJ, eds. Sudden cardiac death in the athlete. Armonk, NY: Futura Publishing, 1998:101-13.
38. Corrado D, McKenna WJ. Appropriate interpretation of the athlete's electrocardiogram saves lives as well as money. Eur Heart J 2007;28:1920-2. (Pubitemid 47579555)
39. Corrado D, Pelliccia A, Heidbuchel H, et al.; Section of Sports Cardiology, European Association of Cardiovascular Prevention and Rehabilitation. Recommendations for interpretation of 12-lead electrocardiogram in the athlete. Eur Heart J 2010;312:243-59. Il recente documento di consenso della sezione "Sports Cardiology" della European Association of Cardiovascular Prevention and Rehabilitation si propone di aggiornare e raffinare i criteri per l'interpretazione dell'ECG negli atleti allo scopo di migliorare la specificità ed ottimizzare il rapporto costo-beneficio dello screening ECG.
40. Thompson PD, Levine BD. Protecting athletes from sudden cardiac death. JAMA 2006;296:1648-50. (Pubitemid 44515021)
41. Corrado D, Basso C, Schiavon M, Thiene G. How much is an athlete's life? [abstract] Eur Heart J 2011;32(Suppl):326.
42. Daviglus ML, Liao Y, Greenland P, et al. Association of nonspecific minor ST-T abnormalities with cardiovascular mortality: the Chicago Western Electric Study. JAMA 1999;281:530-6. (Pubitemid 29081306)
43. De Bacquer D, De Backer G, Kornitzer M, Myny K, Doyen Z, Blackburn H. Prognostic value of ischemic electrocardiographic findings for cardiovascular mortality in men and women. J Am Coll Cardiol 1998;32:680-5. (Pubitemid 28435253)
44. Siscovick DS, Ekelund LG, Johnson JL, Truong Y, Adler A. Sensitivity of exercise electrocardiography for acute cardiac events during moderate and strenuous physical activity. The Lipid Research Clinics Coronary Primary Prevention Trial. Arch Intern Med 1991;151:325-30.
45. Gibbons LW, Mitchell TL, Wei M, Blair SN, Cooper KH. Maximal exercise test as a predictor of risk for mortality from coronary heart disease in asymptomatic men. Am J Cardiol 2000;86:53-8. (Pubitemid 30365143)
46. Laukkanen JA, Kurl S, Lakka TA, et al. Exercise-induced silent myocardial ischemia and coronary morbidity and mortality in middleaged men. J Am Coll Cardiol 2001; 38:72-9. (Pubitemid 32613830)
47. Kodama S, Saito K, Tanaka S, Maki M, Yachi Y, Asumi M. Cardiorespiratory fitness as quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women. A meta-analysis. JAMA 2009;301:2024-35.
48. Albert CM, Mittleman MA, Chae CU, Lee IM, Hennekens CH, Manson JE. Triggering of sudden death from cardiac causes by vigorous exertion. N Engl J Med 2000;343:1355-61.
49. Sassen B, Cornelissen VA, Kiers H, Wittink H, Kok G, Vanhees L. Physical fitness matters more than physical activity in controlling cardiovascular disease risk factors. Eur J Cardiovasc Prev Rehabil 2009;16:677-83.
50. Gibbons RJ, Balady GJ, Bricker JT, et al. ACC/AHA 2002 guideline update for exercise testing: summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines). Circulation 2002;106:1883-92.
51. American College of Sports Medicine. Guidelines for exercise testing and prescription. 7th ed. Baltimore, MD: Lippincott Williams & Wilkins, 2005.
52. Borjesson M, Urhausen A, Kouidi E, et al. Cardiovascular evaluation of middleaged/senior individuals engaged in leisuretime sport activities: position stand from the sections of exercise physiology and sports cardiology of the European Association of Cardiovascular Prevention and Rehabilitation. Eur J Cardiovasc Prev Rehabil 2011;18:446-58.