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Etiology of Sudden Death in Sports: Insights From a United Kingdom Regional Registry
- Source :
- Journal of the American College of Cardiology. 67(18)
- Publication Year :
- 2015
-
Abstract
- Accurate knowledge of causes of sudden cardiac death (SCD) in athletes and its precipitating factors is necessary to establish preventative strategies.This study investigated causes of SCD and their association with intensive physical activity in a large cohort of athletes.Between 1994 and 2014, 357 consecutive cases of athletes who died suddenly (mean 29 ± 11 years of age, 92% males, 76% Caucasian, 69% competitive) were referred to our cardiac pathology center. All subjects underwent detailed post-mortem evaluation, including histological analysis by an expert cardiac pathologist. Clinical information was obtained from referring coroners.Sudden arrhythmic death syndrome (SADS) was the most prevalent cause of death (n = 149 [42%]). Myocardial disease was detected in 40% of cases, including idiopathic left ventricular hypertrophy (LVH) and/or fibrosis (n = 59, 16%); arrhythmogenic right ventricular cardiomyopathy (ARVC) (13%); and hypertrophic cardiomyopathy (HCM) (6%). Coronary artery anomalies occurred in 5% of cases. SADS and coronary artery anomalies affected predominantly young athletes (≤ 35 years of age), whereas myocardial disease was more common in older individuals. SCD during intense exertion occurred in 61% of cases; ARVC and left ventricular fibrosis most strongly predicted SCD during exertion.Conditions predisposing to SCD in sports demonstrate a significant age predilection. The strong association of ARVC and left ventricular fibrosis with exercise-induced SCD reinforces the need for early detection and abstinence from intense exercise. However, almost 40% of athletes die at rest, highlighting the need for complementary preventive strategies.
- Subjects :
- Adult
Male
Adolescent
Coronary Vessel Anomalies
Heart Ventricles
Physical Exertion
Arrhythmias, Cardiac
Cardiomyopathy, Hypertrophic
Fibrosis
United Kingdom
Death, Sudden
Young Adult
Athletes
Humans
Female
Hypertrophy, Left Ventricular
Registries
Arrhythmogenic Right Ventricular Dysplasia
Retrospective Studies
Subjects
Details
- ISSN :
- 15583597
- Volume :
- 67
- Issue :
- 18
- Database :
- OpenAIRE
- Journal :
- Journal of the American College of Cardiology
- Accession number :
- edsair.pmid..........166987f5af678499efff989ca4d935a4