Return to play? Athletes with congenital long QT syndrome
Return to play? Athletes with congenital long QT syndrome
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DOI：
10.1136/bjsports-2012-091751
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发表时间：
2013-01-01
影响因子：
18.4
通讯作者：
Ackerman, Michael J.
中科院分区：
文献类型：
--
作者：
Johnson, Jonathan N.;Ackerman, Michael J.
背景先天性长QT综合征（LQTS）运动员参加竞技体育比赛的指导原则是2005年第36届贝塞斯达会议和2005年欧洲心脏病学会（ESC）指南。本研究的目的是确定LQTS患者的患病率和结果谁选择留在运动员以下diagnosis.Methods所有患者的记录6至40岁之间的第一次评估马约诊所的LQTS诊所从2000年7月至2010年11月进行了审查，记录运动参与后LQTS诊断和LQTS相关事件在后续。结果该队列包括353例LQTS患者（199例女性，平均年龄17 ± 11岁，平均QTc 472 ± 42 ms），其中182例为LQT 1型，130例为LQT 2型，37例为LQT 3型，4例为多重LQTS突变。大多数患者（223，63%）在评估后要么不参与运动（88%），要么选择停止运动（12%）。130例患者（37%，60例女性，平均年龄11 ± 7岁，平均QTc 471 ± 46 ms）仍参加竞技运动，包括20例植入式心律转复除颤器（ICD）。在这130例患者中，70例（54%）为基因型阳性/表型阴性，与ESC指南相反，但在Bethesda指南范围内。这些运动员中没有一个参加过与体育有关的活动。60 LQTS运动员继续在运动中违反了Bethesda和ESC的指导方针（基因型阳性/表型阳性），只有一个有适当的ICD shock.Conclusions运动员和他们的家庭是完全能够自我取消资格的运动相关事件。在那些选择继续参加竞技运动的LQTS运动员中，在超过650个运动员年的随访中观察到心脏事件发生率较低，没有死亡。目前基于指南的取消资格的建议可能对这种疾病过度。
Background Competitive sports participation for athletes with congenital long QT syndrome (LQTS) is guided by the 2005 36th Bethesda Conference and the 2005 European Society of Cardiology (ESC) guidelines. The purpose of this study was to determine the prevalence and outcomes of patients with LQTS who chose to remain athletes following their diagnosis.Methods Records of all patients between 6 and 40 years of age who were first evaluated in Mayo Clinic's LQTS Clinic from July 2000 to November 2010 were reviewed, for documentation of athletic participation after LQTS diagnosis and LQTS-related events during follow-up. Average follow-up was 5.5 +/- 3.4 years.Results The cohort included 353 patients with LQTS (199 females, mean age 17 +/- 11 years, mean QTc 472 +/- 42 ms), of whom 182 had LQT1, 130 had LQT2, 37 had LQT3 and 4 had multiple LQTS mutations. The majority of patients (223, 63%) were either not involved in sports (88%) or chose to discontinue sports (12%) following evaluation. 130 patients (37%, 60 females, mean age 11 +/- 7 years, mean QTc 471 +/- 46 ms) remained in competitive athletics, including 20 with implantable cardioverter defibrillators (ICDs). Of these 130, 70 (54%) were genotype-positive/phenotype-negative and competing contrary to ESC guidelines but within the Bethesda guidelines. None of these athletes had a sport-related event. Of the 60 LQTS athletes continuing in sports contrary to both the Bethesda and ESC guidelines (genotype-positive/phenotype-positive), only one had a sporting-related event with appropriate ICD shock.Conclusions Athletes and their families are fully capable of self-disqualification. Among those athletes with LQTS who chose to remain in competitive sports, a low rate of cardiac events and no deaths were observed in over 650 athlete-years of follow-up. Current guideline-based recommendations for disqualification may be excessive for this disease.