Pre-participation cardiovascular evaluation in Pacific Island athletes
- •This study provides new information on cardiovascular diseases in male and female Pacific Island athletes and in low and highly trained athletes.
- •Melanesians had a higher rate of T waves inversion in V2-V4 than others and were similar to those in Afro-Caribbean athletes.
- •The prevalence of valvular diseases of rheumatoid origin was clearly higher than in Western and Middle East countries.
Pre-participation cardiovascular evaluation (PPE) aims to detect cardiac disease with sudden cardiac death (SCD) risk. No study has focused on Pacific Island athletes.
A total of 2281 Pacific Island athletes were studied with (i) a questionnaire on family, personal history and symptoms, (ii) a physical examination and (iii) a 12-lead ECG.
85% presented a normal history and examination. A positive family history was 1.4–1.9 fold higher in Melanesians, Polynesians and Métis than in Caucasians, while a positive personal history, abnormal symptoms and abnormal examination was 1.3 fold higher in Melanesians and Métis than in others. Neither gender nor training level had a bearing on these results. Melanesians had higher T wave inversions (TWIs) in V2–V4 leads but had no CV abnormalities. Lateral or infero-lateral TWIs were found in 6 male and in 5 highly trained athletes and cardiomyopathies were diagnosed in 3/6 athletes. Overall, 3.9% athletes were found to have a CV abnormality and 0.8% had a risk of SCD. Polynesians and males were more at risk than the others while the level of training made no difference. In athletes at risk of SCD, the main detected CV diseases were cardiomyopathies, Wolff-Parkinson-White (WPW) and severe valve lesions of rheumatoid origin.
PPE revealed that 3.9% presented CV abnormalities. A risk of SCD was found in 0.8% with cardiomyopathies, WPW, and severe valve lesions of rheumatoid origin. Melanesians, Polynesians and male of high level of training were more at risk than others.
Keywords:Pre-participation cardiovascular evaluation, Cardiomyopathy, Sudden cardiac death, T wave inversion, Melanesians, Polynesians
Autor / Fonte:Jean-Claude Chatard, Florian Espinosa, Richard Donnadieu et al. International Journal of Cardiology 2018 November 16