TY - JOUR
T1 - Pre-participation screenings frequently miss occult cardiovascular conditions in apparently healthy male middle-aged first-time marathon runners
AU - Laily, Inarota
AU - Wiggers, Tom G H
AU - van Steijn, Niels
AU - Bijsterveld, Nick
AU - Bakermans, Adrianus J
AU - Froeling, Martijn
AU - van den Berg-Faay, Sandra
AU - de Haan, Ferdinand H
AU - de Bruin-Bon, Rianne H A C M
AU - Boekholdt, S Matthijs
AU - Planken, R Nils
AU - Verhagen, Evert
AU - Jorstad, Harald T
N1 - The Author(s). Published by S. Karger AG, Basel.
PY - 2024/2/7
Y1 - 2024/2/7
N2 - INTRODUCTION: The optimal pre-participation screening strategy to identify athletes at risk for exercise-induced cardiovascular events is unknown. We therefore aimed to compare the American College of Sports Medicine (ACSM) and European Society of Cardiology (ESC) pre-participation screening strategies against extensive cardiovascular evaluations in identifying high-risk individuals among 35-50-year-old apparently healthy men.METHODS: We applied ACSM and ESC pre-participation screenings to 25 men participating in a study on first-time marathon running. We compared screening outcomes against medical history, physical examination, electrocardiography, blood tests, echocardiography, cardiopulmonary exercise testing, and magnetic resonance imaging.RESULTS: ACSM screening classified all participants as 'medical clearance not necessary'. ESC screening classified two participants as 'high-risk'. Extensive cardiovascular evaluations revealed ≥1 minor abnormality and/or cardiovascular condition in 17 participants, including three subjects with mitral regurgitation and one with a small atrial septal defect. Eleven participants had dyslipidaemia, six had hypertension, and two had premature atherosclerosis. Ultimately, three (12%) subjects had a serious cardiovascular condition warranting sports restrictions: aortic aneurysm, hypertrophic cardiomyopathy (HCM), and myocardial fibrosis post-myocarditis. Of these three participants, only one had been identified as 'high-risk' by the ESC screening (for dyslipidaemia, not HCM) and none by the ACSM screening.CONCLUSION: Numerous occult cardiovascular conditions are missed when applying current ACSM/ESC screening strategies to apparently healthy middle-aged men engaging in their first high-intensity endurance sports event.
AB - INTRODUCTION: The optimal pre-participation screening strategy to identify athletes at risk for exercise-induced cardiovascular events is unknown. We therefore aimed to compare the American College of Sports Medicine (ACSM) and European Society of Cardiology (ESC) pre-participation screening strategies against extensive cardiovascular evaluations in identifying high-risk individuals among 35-50-year-old apparently healthy men.METHODS: We applied ACSM and ESC pre-participation screenings to 25 men participating in a study on first-time marathon running. We compared screening outcomes against medical history, physical examination, electrocardiography, blood tests, echocardiography, cardiopulmonary exercise testing, and magnetic resonance imaging.RESULTS: ACSM screening classified all participants as 'medical clearance not necessary'. ESC screening classified two participants as 'high-risk'. Extensive cardiovascular evaluations revealed ≥1 minor abnormality and/or cardiovascular condition in 17 participants, including three subjects with mitral regurgitation and one with a small atrial septal defect. Eleven participants had dyslipidaemia, six had hypertension, and two had premature atherosclerosis. Ultimately, three (12%) subjects had a serious cardiovascular condition warranting sports restrictions: aortic aneurysm, hypertrophic cardiomyopathy (HCM), and myocardial fibrosis post-myocarditis. Of these three participants, only one had been identified as 'high-risk' by the ESC screening (for dyslipidaemia, not HCM) and none by the ACSM screening.CONCLUSION: Numerous occult cardiovascular conditions are missed when applying current ACSM/ESC screening strategies to apparently healthy middle-aged men engaging in their first high-intensity endurance sports event.
U2 - 10.1159/000536553
DO - 10.1159/000536553
M3 - Article
C2 - 38325343
SN - 1047-9511
JO - Cardiology in the young
JF - Cardiology in the young
ER -