Comparison of the Frequency of Sudden Cardiovascular Deaths in Young Competitive Athletes vs. Non-athletes: should we really screen only Athletes?
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 ECGs 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, 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 non-athletes (n=24) than athletes (n=3), and 3-fold 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.
Autor / Fonte:Barry J. Maron, Tammy S. Haas, Emily R. Duncanson, Ross F. Garberich, Andrew M. Baker, Shannon Mackey-Bojack Publication stage: In Press Accepted Manuscript American Journal of Cardiology Published online: February 1 2016