cardiovascular screening
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2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Patrizio Sarto ◽  
Alessandro Zorzi ◽  
Laura Merlo ◽  
Teresina Vessella ◽  
Cinzia Pegoraro ◽  
...  

Abstract The primary objective of preparticipation cardiovascular evaluation (PPCE) in young athletes is to detect asymptomatic individuals with cardiovascular disease (CVD) at risk of sudden cardiac death (SCD). The study population included a consecutive series of competitive athletes age 12–18 years who underwent PPCE, which according to Italian law is mandatory and based on yearly evaluations, at the Center for Sports Medicine of Treviso (Veneto region of Italy), from 2009 to 2019. The screening protocol included personal and family history questionnaire, physical examination, resting 12-lead ECG, and limited stress testing for evaluation of exertional ventricular arrhythmias. 2,3 This latter test was performed using a bicycle with constant-load increases (i.e. 2 W/kg in female participants and 3 W/kg in male participants) for 3 min for at least 85% or more of maximal heart rate was achieved, plus 3 min of postexercise monitoring. 3 Athletes with a positive medical history and abnormal physical examination, ECG, or stress test underwent further investigations. The diagnostic yield of the initial screening session was compared with that of repeat PPCEs. Athletes with a definitive diagnosis of CVD at risk of SCD were considered ineligible for competitive sports, although they received a tailored programme for leisure physical activity and were enrolled in a yearly follow-up programme. Outcome data of screened athletes, either eligible or ineligible to play competitive sports, were obtained from office visits, hospital records, or interrogation of the Registry of Juvenile SCD of the Veneto region. The study population included 15 127 consecutive athletes (64% male, 96% White) who underwent a total of 53 396 annual PPCEs (mean 3.7 per athlete) over the 11-year study period. The median age at first screening was 13 years [interquartile range (IQR): 12–14]. Sixty-three athletes (65% male) were diagnosed with a CVD at risk of SCD such as congenital heart disease (n = 17), ion channel disease (n = 11), inherited cardiomyopathy (n = 13), isolated nonischaemic left ventricular scar (NLVS) with ventricular arrhythmias (n = 18), or other (n = 4); 266 athletes had cardiac conditions not associated with SCD. Seventeen of the 63 athletes (27%) with atrisk CVD had a positive family history, symptoms, or abnormal physical examination, 38 (60%) had ECG abnormalities, and 32 (51%) developed arrhythmias on limited exercise testing. CVDs more frequently identified on repeat evaluation included inherited cardiomyopathies [7/11 (64%)], NLVS with ventricular arrhythmias [15/18 (83%)], and long QT syndrome [7/11 (64%)]. During a mean follow-up of 6.7 ± 3.5 years, 1 athlete with a negative PPCE experienced an episode of aborted SCD attributable to ventricular fibrillation that remained unexplained after a comprehensive diagnostic workup (event rate, 0.98/100 000 athletes per year). These results show that annual cardiovascular screening of adolescent athletes increased by three times the diagnostic yield of CVD at risk of SCD compared with a once-only (initial) evaluation. Inherited cardiomyopathies and isolated NLVS with ventricular arrhythmias were the CVDs more frequently identified on repeat evaluation.


2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Goffredo Orlandi ◽  
Lorenzo Casatori ◽  
Marco Corsi ◽  
Loira Toncelli ◽  
Maria Boddi ◽  
...  

Abstract Aims Fragmented QRS (fQRS), defined as the presence of additional peaks within the QRS complex (<120 ms) in at least two contiguous leads, was considered as a pattern of fibrosis. However, fQRS can also be detected during pre-participation cardiovascular screening. To assess determinants of fQRS in athletes of different sports. Methods and results Retrospective study conducted on 605 non-sedentary subjects undergoing pre-participation cardiovascular screening for competitive activity in six disciplines (athletics, football, cycling, swimming, basketball, and volleyball). All subjects underwent ECG for the search of fQRS and transthoracic echocardiography. Predictors of fQRS were investigated using multivariate logistic analysis adjusted for. fQRS was found in 47 of 605 subjects. On multivariate logistic analysis, fQRS was positively associated with age (OR: 1.03; 95% CI: 1.01–1.05), male sex (OR: 0.35; 95% CI: 0.13–0.94), whereas no association with sport discipline was observed (0.91; 0.73–1.12). When echocardiographic parameters were considered, fQRS was associated with cardiac mass index (OR: 1.02; 95% CI: 1.00–1.03) and E wave (OR: 0.98; 95% CI: 0.96–0.99). Conclusions At pre-participation cardiovascular screening, the fQRS finding increases with age, is more frequent in males, and seems to be independent from practiced sport. Furthermore, fQRS in athletes appears to be associated with parameters of physiological hypertrophy (LV cardiac mass index and diastolic function).


Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3778
Author(s):  
Roberta Adorni ◽  
Francesco Zanatta ◽  
Marco D'Addario ◽  
Francesca Atella ◽  
Elena Costantino ◽  
...  

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality globally. Promoting healthy behaviors throughout life is an essential prevention tool. This study investigated the associations among lifestyle profiles (including diet, alcohol consumption, physical activity, cigarette smoking, and cardiovascular screening), sociodemographic factors (gender, age, education, and family history of CVDs), and psychological factors (sense of coherence and dispositional optimism). In total, 676 healthy adults (mean age = 35 years; range = 19–57; 46% male) participated in an online survey. Lifestyle profiles were identified through cluster analysis, and a multinomial logistic regression was then performed to explore their association with sociodemographic and psychological variables. Results show that men were more likely than women to belong to the lifestyle profile with the highest amount of physical activity (OR = 2.40; p < 0.001) and the greatest attention to cardiovascular screening (OR = 2.09; p < 0.01). Lower dispositional optimism was associated with the profile paying the greatest attention to cardiovascular screening (OR = 0.67; p < 0.05). Sense of coherence, in terms of lower comprehensibility (OR = 0.67; p < 0.05) and higher manageability (OR = 1.43; p < 0.05), was associated with the lifestyle profile characterized by an unhealthy diet, sedentary lifestyle, and nonsmoking. This study shed light on factors associated with different co-occurring health-related behaviors that should be considered in planning effective communication strategies promoting adherence to health claims.


2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
B N Morrison ◽  
S Isserow ◽  
M MacDonald ◽  
C Cater ◽  
I Zwaiman ◽  
...  

Abstract Background The long-term implications of cardiovascular disease (CVD) in masters athletes, and whether screening decreases their risk of major adverse cardiac events (MACE) is unknown. Purpose To evaluate the incidence of CVD and MACE over five years of a screening study. Methods Masters athletes (≥35 years) from a variety of sports without previous history of coronary artery disease (CAD) underwent yearly cardiovascular screening. The screen consisted of anthropometrics, blood pressure, resting electrocardiogram, modified American Heart Association 14-element recommendations, cardiovascular event questionnaire, physical examination (year 1) and Framingham Risk Score (years 1–3). Participants with an abnormal screen according to the European Association of Cardiovascular Prevention and Canadian Cardiology Society Guidelines underwent further evaluations (computed coronary tomography angiography was not included for all athletes but based on clinical assessment). Participants who withdrew during the study received a follow-up questionnaire to determine MACE and vital status. Results In the first year of the Masters Athlete Screening Study, 798 masters athletes (62.7% male, 54.6±9.5 years) were screened; 91 (11.4%) of the cohort were found to have CVD. CAD was the most common diagnosis (69.2%). During the following four years, there were an additional 89 CVD diagnoses with an incidence rate of 3.58/100, 4.14/100, 3.74/100, 1.19/100, for years two to five, respectively. Fifteen participants had more than one diagnosis. The most common diagnoses over the five years were arrhythmias (n=33; 37.1%), aortic dilatation (n=20; 22.5%), CAD (n=18; 20.2% (5 obstructive, 13 non-obstructive)) and other (n=7; 7.9%) (myocarditis (n=2), myocardial bridging (n=1), cerebrovascular disease (n=1), dilated cardiomyopathy (n=1), probable Long QT syndrome (n=1), papillary fibroelastoma (n=1)). A total of 10 MACE occurred (two cardiovascular deaths, five myocardial infarctions and three cerebrovascular accidents). All events occurred in male athletes (63.6±12.5 years). Out of the 136 participants that received the lost to follow-up questionnaire, 101 (74.3%) completed it. Of those, one male athlete underwent percutaneous coronary intervention. The incidence of MACE over the study period was 0.30/100 athletes per year. Conclusion Yearly cardiovascular screening of masters athletes identified ∼3 new diagnoses per 100 athletes per year. Ten MACE occurred despite yearly screening and high CV fitness of masters athletes. FUNDunding Acknowledgement Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): MITACs and CIHR


Author(s):  
Samantha Benton ◽  
Erika Mery ◽  
David Grynspan ◽  
Laura Gaudet ◽  
Graeme Smith ◽  
...  

Objective: To determine the association between placental lesions and lifetime cardiovascular disease (CVD) risk screening at 6 months postpartum following preeclampsia (PE). Design: Observational cohort study. Setting: Tertiary care centres in Ottawa and Kingston, Ontario, Canada. Population: Women diagnosed with PE who received cardiovascular screening at 6 months postpartum. Methods: Placentas from women diagnosed with PE were evaluated for histopathological lesions according to a standardised synoptic data collection form with blinding to clinical outcomes apart from gestational age at delivery. At 6 months postpartum, each participant was screened for cardiovascular risk factors and a lifetime cardiovascular risk score was calculated. A risk score >35% was deemed high risk for lifetime CVD. Main Outcome Measures: The association between placental lesions and lifetime CVD risk was assessed using odds ratios (OR, 95% confidence intervals). Results: Of the 85 participants, 53 (62.4%) screened high-risk for lifetime CVD. High-risk women had more severe lesions of maternal vascular malperfusion (MVM). MVM lesions with a severity score >2 resulted in a 3-fold increased risk of screening high risk for lifetime CVD (OR 3.10 [1.20-7.92]). MVM lesion score >2 was moderately predictive of high-risk screening (AUC 0.63 [0.51,0.75]; sensitivity: 71.8% [54.6,84.4]; specificity: 54.7% [41.5,67.3]). When clinical data was added, the model’s predictive performance improved (AUC 0.73 [0.62,0.84] sensitivity 78.4% [65.4,87.5]; specificity 51.6% [34.8,68.0]). Conclusions: PE women with MVM are more likely to screen high-risk for lifetime CVD compared to women without these lesions. Placenta pathology may provide a unique modality to identify women for postpartum cardiovascular screening.


2021 ◽  
Vol 37 (2) ◽  
pp. 96-103
Author(s):  
Junpei Kawamura ◽  
Yuichi Nomura ◽  
Naohiro Shiokawa ◽  
Daisuke Hazeki ◽  
Kentaro Ueno ◽  
...  

Author(s):  
Marleen Vonder ◽  
Sunyi Zheng ◽  
Monique D. Dorrius ◽  
Carlijn M. van der Aalst ◽  
Harry J. de Koning ◽  
...  

Men's Health ◽  
2021 ◽  
pp. 147-154
Author(s):  
Raghav T. Bhatia ◽  
Sarandeep Marwaha ◽  
Sanjay Sharma

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