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Electrocardiographic criteria to detect cardiac abnormalities in athletes – a Portuguese study
Session:
Painel 4 - Arritmologia 9
Speaker:
Pedro von Hafe Leite
Congress:
CPC 2020
Topic:
J. Preventive Cardiology
Theme:
29. Rehabilitation and Sports Cardiology
Subtheme:
29.3 Sports Cardiology
Session Type:
Posters
FP Number:
---
Authors:
Pedro Von Hafe Leite; Bebiana Faria; Geraldo Dias; Ana Filipa Cardoso; Tamara Pereira; João Português; Lucy Calvo; António Lourenço
Abstract
<p><strong>Background:</strong> Electrocardiogram (ECG) has been included in most sport screening programs worldwide. Improvement of the criteria defining the electrocardiographic changes that suggest cardiac pathology had its last breakthrough in 2017 with the publication of new guidelines, replacing the 2013 Seattle criteria.</p> <p><strong>Purpose:</strong> To assess the accuracy of the international consensus criteria (ICC) for electrocardiogram interpretation to detect cardiac anomalies during athlete screening.</p> <p><strong>Methods:</strong> ECGs of 2000 elite and leisure athletes (aged 5 to 65 years old), that were submitted to sport pre-participation evaluation were analyzed retrospectively using ICC.</p> <p>All athletes underwent a two-dimensional echocardiogram.</p> <p><strong>Results:</strong> Of the revised ECGs, 19 had abnormal findings, namely: ventricular pre-excitation (42.1%, n=8), inverted T-wave in leads other than V1-V3 (36.8%, n=7), complete left bundle branch block (5.3%, n=1), ≥2 premature ventricular contraction (5.3%, n=1), pathologic Q waves (5.3%, n=1) and atrial tachyarrhythmias (5.3%, n=1).</p> <p>Of these, 10 (52.6%) were soccer players, 4 (21.1%) leisure athletes and 1 (5.3%) athlete for each of the following modalities: athletics, basketball, kickboxing, table tennis and volleyball. This group included two women and two black athletes (10.5%). Mean age was 25.47 ± 18.65 years. </p> <p>Among the athletes with normal ECG, seven had structural heart disease documented on echocardiogram. Bicuspid aortic valve with mild regurgitation, atrial septal defect, ventricular septal defect, aortic dilatation, left ventricular dysfunction, mitral valve prolapse with mild regurgitation and left ventricular noncompaction were detected (n= 1, each). Four were soccer players, two were referees and one was a leisure athlete. All of them were male, one black and mean age was 19.86 ± 9.35 years.</p> <p>The calculated sensitivity of ICC to detect cardiac abnormalities was 58.82% (95% CI, 36.01-78.39%) and specificity was 99.14% (95% CI, 99.14-99.76%). Positive predictive value was 52.63% (95% CI, 31.71-72.67%) and negative predictive value was 99.65% (95% CI, 99.27-99-83%).</p> <p><strong>Conclusion:</strong> There are few studies validating on the accuracy of screening using the new ECG criteria and, to our knowledge, this is the only series described in the literature with athletes in Portugal.</p> <p>In this sample, the sensitivity of ICC to detect cardiac abnormalities was 58.82% and the specificity of 99.14%, similar to that described elsewhere in literature.</p>
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