Benefits and limitations of cardiovascular pre-competition screening in international football

Abstract

Cardiovascular pre-competition screening proved feasible in international elite football teams, but turned out to be vital to ensure high quality of data, particularly with regard to stress testing and echocardiography. The screening concept was revised mainly to improve completeness and quality of data acquisition. Resting ECG and echocardiography were retained, but it is questionable if exercise testing should be included in this context.

How to Practice Sports Cardiology

“…In 582 professional soccer players undergoing cardiac assessment at the 2006 FIFA World Cup, 4.8% were found to have a potentially ''pathologic'' ECG, most commonly caused by T wave inversion. 17 Echocardiographic data in the same group suggest that ventricular enlargement is common: 30% of players demonstrate left ventricular end-diastolic dimension greater than 55 mm, whereas 10% show right ventricular end-diastolic dimension greater than 30 mm. Normal left ventricular ejection fraction ranges 45% to 85% in soccer players, whereas left atrial and aortic dimensions are 22 to 49 (mean, 36 AE 4) and 19 to 43 (mean, 31 AE 3) mm, respectively.…”

Assessment of the 12-Lead ECG as a Screening Test for Detection of Cardiovascular Disease in Healthy General Populations of Young People (12–25 Years of Age)

“…Most of these come from Italian investigators (n=19) and others (n=14), who suggest that the ECG is a reliable and economically feasible diagnostic test, some prematurely pronouncing a paradigm shift, 49,78 whereas others appear contradictory 49,85 ; other statements have come from an American Heart Association (AHA) science advisory 87 and a report from the National Institutes of Health. 23 Indeed, the issue of preparticipation athlete screening for cardiovascular disease has become the subject of discussion in a number of countries, including the United States,* Italy, 4,18,31 Israel, 28,29,31,92,93 Germany, 94 Sweden, 95 the United Kingdom, 60,96 China, 97 the Netherlands, 98 France, 99 Norway, 58 Denmark, 5,100 Japan, 101,102 Switzerland, 103 and Spain. 104 The present discussion defines cardiovascular screening as an initiative intended to prospectively identify or raise suspicion of previously unrecognized and largely genetic or congenital cardiovascular diseases known to cause sudden cardiac arrest and SD in young people.…”

“…For example, among the nearly 90 000 athletes screened, there were only 6 definitive diagnoses of HCM, 91,94,104,255 although 38 other athletes with increased septal thickness >13 mm were noted (Table 2). Explanations for the low frequency of HCM diagnoses are elusive, given that a number of independent surveys worldwide have identified HCM to occur in at least 1 in 500 of the general population (0.2%).…”

Empfehlungen für den internistischen Untersuchungsgang in der Sportmedizin

“…Als obligat ist sie vor allem bei Hochleistungssportlern sowohl in Ausdauer-als auch Kraftsportarten anzusetzen. Dies wird u. a. im internationalen Fuß-ball obligatorisch empfohlen [36]. Bezüglich der Normwerte wird auf Tabelle 3 für die linksventrikuläre Größe, auf Tabelle 4 für die Größe des rechten Ventrikels verwiesen [37].…”