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- Title
Pre-Participation Screenings Frequently Miss Occult Cardiovascular Conditions in Apparently Healthy Male Middle-Aged First-Time Marathon Runners.
- Authors
Laily, Inarota; Wiggers, Tom G.H.; van Steijn, Niels; Bijsterveld, Nick; Bakermans, Adrianus J.; Froeling, Martijn; van den Berg-Faay, Sandra; de Haan, Ferdinand H.; de Bruin-Bon, Rianne H.A.C.M.; Boekholdt, S. Matthijs; Planken, R. Nils; Verhagen, Evert; Jorstad, Harald T.
- Abstract
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.
- Subjects
AMERICAN College of Sports Medicine; EUROPEAN Society of Cardiology; MIDDLE-aged persons; ENDURANCE athletes; MEDICAL screening; VASOMOTOR conditioning; ATRIAL septal defects; MARATHON running; MAGNETIC resonance imaging
- Publication
Cardiology, 2024, Vol 149, Issue 3, p255
- ISSN
0008-6312
- Publication type
Article
- DOI
10.1159/000536553