Preventing Sudden Cardiac Death in Athletes: in Search of Evidence-based, Cost-effective Screening

Authors

Paolo Angelini
Mladen I Vidovich
Christine E Lawless
Macarthur A Elayda
J Alberto Lopez
Dwayne Wolf
James T Willerson

Publication Date

2013

Journal

The Texas Heart Journal

PMID

23678212

Publication Date(s)

2013

Language

English

PMCID

PMC3649790

PubMedCentral® Posted Date

2013

PubMedCentral® Full Text Version

Post-Print

Published Open-Access

yes

Keywords

Adolescent, adult, arrhythmias, cardiac/complications, coronary vessel anomalies/complications, death, sudden, cardiac/etiology/prevention & control, guidelines as topic, heart defects, congenital/diagnosis, magnetic resonance angiography, mass screening/standards, practice guidelines as topic, preventive medicine, sports medicine

Copyright

This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.

Abstract

Sudden cardiac death in athletes is a recurrent phenomenon at sporting events and during training. Recent studies have associated sudden cardiac death with such cardiovascular conditions as coronary artery anomalies, cardiomyopathies, and electrocardiographic abnormalities, most of which are screenable with modern imaging techniques. We recently inaugurated the Center for Coronary Artery Anomalies at the Texas Heart Institute, which is dedicated to preventing sudden cardiac death in the young and investigating coronary artery anomalies. There, we are conducting 2 cross-sectional studies intended to firmly establish and quantify, in a large group of individuals from a general population, risk factors for sudden cardiac death that arise from specific cardiovascular conditions.

In a pilot screening study, we are using a brief, focused clinical questionnaire, electrocardiography, and a simplified novel cardiovascular magnetic resonance screening protocol in approximately 10,000 unselected 11- to 15-year-old children. Concurrently, we are prospectively studying the prevalence of these same conditions, their severity, and their relation to exercise and mode of death in approximately 6,500 consecutive necropsy cases referred to a large forensic center. Eventually, we hope to use our findings to develop a more efficient method of preventing sudden cardiac death in athletes. We believe that these studies will help quantify sudden cardiac death risk factors and the relevance of associated physical activities—crucial information in evaluating the feasibility and affordability of cardiovascular magnetic resonance-based screening. We discuss the rationale for and methods of this long-term endeavor, in advance of reporting the results.