Comparison of the Frequency of Sudden Cardiovascular Deaths in Young Competitive Athletes Versus Nonathletes: Should We Really Screen Only Athletes?
Comparison of the Frequency of Sudden Cardiovascular Deaths in Young Competitive Athletes Versus Nonathletes: Should We Really Screen Only Athletes?
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DOI：
10.1016/j.amjcard.2016.01.026
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发表时间：
2016-04-15
影响因子：
2.8
通讯作者：
Mackey-Bojack, Shannon
中科院分区：
文献类型：
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作者：
Maron, Barry J.;Haas, Tammy S.;Mackey-Bojack, Shannon
关于年轻运动员猝死的问题，以及考虑采取最实际和最佳的战略以查明造成这些悲惨事件的遗传性和/或先天性心脏病的问题，仍在辩论之中。然而，广泛和强制性的国家参与前筛查的支持者，包括12导联心电图，将重点限制在相对较小的一小部分年轻人，他们选择参加高中、大学和精英专业水平的竞技体育项目。因此，在关于运动员参与前筛查的讨论中，遗漏了更多没有参与竞技运动的年轻人(因此，先验地被排除在系统筛查之外)，他们可能会突然死于与运动员相同的心血管疾病。为了证实这一假设，我们访问了明尼苏达州亨内平县的法医登记，其中非运动员(n=24)心血管猝死的发生率是运动员(n=3)的8倍，发病率是运动员的3倍。猝死最常见的疾病是肥厚型心肌病(6例)和致心律失常性右室心肌病(4例)。这些数据提出了将意外遗传性和/或先天性心脏病的系统筛查限制在竞技运动员身上所固有的伦理考虑。(C)2016 Elsevier Inc.保留所有权利。
The issue of sudden death in young athletes and consideration for the most practical and optimal strategy to identify those genetic and/or congenital heart diseases responsible for these tragic events continues to be debated. However, proponents of broad-based and mandatory national preparticipation screening, including with 12-lead electrocardiograms have confined the focus to a relatively small segment of the youthful population who choose to engage in competitive athletic programs at the high school, college, and elite-professional level. Therefore, lost in this discussion of preparticipation screening of athletes is that the larger population of young people not involved in competitive sports (and, therefore, a priori are excluded from systematic screening) who nevertheless may die suddenly of the same cardiovascular diseases as athletes. To substantiate this hypothesis, we accessed the forensic Hennepin County, Minnesota registry in which cardiovascular sudden deaths were 8-fold more common in nonathletes (n = 24) than athletes (n = 3) and threefold more frequent in terms of incidence. The most common diseases responsible for sudden death were hypertrophic cardiomyopathy (n = 6) and arrhythmogenic right ventricular cardiomyopathy (n = 4). These data raise ethical considerations inherent in limiting systematic screening for unsuspected genetic and/or congenital heart disease to competitive athletes. (C) 2016 Elsevier Inc. All rights reserved.