1. Pre-Participation Screenings Frequently Miss Occult Cardiovascular Conditions in Apparently Healthy Male Middle-Aged First-Time Marathon Runners.
- Author
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Laily, Inarota, Wiggers, Tom G.H., van Steijn, Niels, Bijsterveld, Nick, Bakermans, Adrianus J., Froeling, Martijn, van den Berg-Faay, Sandra, de Haan, Ferdinand H., de Bruin-Bon, Rianne H.A.C.M., Boekholdt, S. Matthijs, Planken, R. Nils, Verhagen, Evert, and Jorstad, Harald T.
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MIDDLE-aged persons , *ENDURANCE athletes , *MEDICAL screening , *VASOMOTOR conditioning , *ATRIAL septal defects , *MARATHON running , *MAGNETIC resonance imaging - Abstract
Introduction: The optimal pre-participation screening strategy to identify athletes at risk for exercise-induced cardiovascular events is unknown. We therefore aimed to compare the American College of Sports Medicine (ACSM) and European Society of Cardiology (ESC) pre-participation screening strategies against extensive cardiovascular evaluations in identifying high-risk individuals among 35–50-year-old apparently healthy men. Methods: We applied ACSM and ESC pre-participation screenings to 25 men participating in a study on first-time marathon running. We compared screening outcomes against medical history, physical examination, electrocardiography, blood tests, echocardiography, cardiopulmonary exercise testing, and magnetic resonance imaging. Results: ACSM screening classified all participants as "medical clearance not necessary." ESC screening classified two participants as "high-risk." Extensive cardiovascular evaluations revealed ≥1 minor abnormality and/or cardiovascular condition in 17 participants, including three subjects with mitral regurgitation and one with a small atrial septal defect. Eleven participants had dyslipidaemia, six had hypertension, and two had premature atherosclerosis. Ultimately, three (12%) subjects had a serious cardiovascular condition warranting sports restrictions: aortic aneurysm, hypertrophic cardiomyopathy (HCM), and myocardial fibrosis post-myocarditis. Of these three participants, only one had been identified as "high-risk" by the ESC screening (for dyslipidaemia, not HCM) and none by the ACSM screening. Conclusion: Numerous occult cardiovascular conditions are missed when applying current ACSM/ESC screening strategies to apparently healthy middle-aged men engaging in their first high-intensity endurance sports event. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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