Hypertrophic cardiomyopathy (HCM) is the number one cause of sudden cardiac death in elite athletes. This project used resting 12-lead electrocardiography (ECG) and ballistocardiography (BCG) to assess cardiac cycle timing events as simple screening techniques to rule out cardiac abnormalities for the safety of a group of elite ice hockey players. Clinical cardiac (ECG) and physiological (maximal aerobic power [VO 2 max], anaerobic [Wingate peak power, Watts] and musculoskeletal strength) data is presented here on an elite group of ice hockey players (n=34; age=17-18 yrs) that participated in a professional medical and fitness evaluation. Subsequently one subject was diagnosed with #1 Apical HCM and his cardiac data is compared with the group. The HCM subject performed all fitness testing and was determined to be physically fit (%BF=7.2%; VO 2 max=59.4 mL•kg -1 •min -1 ; Wingate peak power output=15.1 Watt•kg -1 ; Heart Rate max=200 beats•min -1 ). However, the ECG showed extreme voltage and deeply inverted T-waves, and the BCG showed abnormal waveform complexes and cardiac timing events in comparison to the group means. Mean BCG systolic timing events for isovolumic contraction time ) and LV ejection fraction (62%). Cardiac magnetic resonance imaging (MRI) showed apical septal wall thickness (24-25 mm) in the HCM player. In conclusion, BCG was able to corroborate a cardiac abnormality that was later confirmed with echocardiography and MRI, suggesting that BCG is a potential technology to detect anomalies that alter cardiac timing and amplitude.
OBJECTIVE:The purpose of this study was to examine the impact of applying six commonly-used and two proposed resting blood pressure (BP) cut-points to clear individuals for maximal exercise in non-clinical health, wellness, commercial fitness agencies and physically demanding occupation test sites. METHODS: Participants (n = 1670) completed the Physical Activity Readiness Questionnaire for Everyone (PAR-Q+) and had their resting BP measured. Individuals with a BP >160/90 mmHg were further screened for contraindications to exercise using the ePARMed-X+ (www.eparmedx.com), all 1670 were cleared. There were no adverse events during or post exercise.
RESULTS:The percentages of participants cleared for each BP cut-point were: <130/80 mmHg (85.3%), <140/90 mmHg (93.4%), <144/90 mmHg (94.6%), <144/94 mmHg (96.3%), <150/100 mmHg (98.6%), <160/90 mmHg (95.6%), <160/94 mmHg (97.8%) and <160/100 mmHg (99.5%). Individuals who would not have been cleared without further screening were significantly older, had a higher BMI, or had a lower maximal oxygen consumption. CONCLUSIONS: Conservative or lower resting BP cut-points currently applied to clear individuals for maximal exercise provide an unnecessary barrier. For individuals categorized as low-to-moderate risk by evidence-based screening tools such as the PAR-Q+ and ePARmed-X+, we recommend a resting BP cut-point of <160/94 mmHg to clear for maximal exercise until sufficient evidence is amassed to support the increase to <160/100 mmHg.
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