title: Focused physician-performed echocardiography in sports medicine: a potential screening tool for detecting aortic root dilatation in athletes.
abstract: OBJECTIVE
  The purpose of this study was to investigate whether sports medicine physicians can obtain accurate measurements of the aortic root in young athletes.
  
  
  METHODS
  Twenty male collegiate athletes, aged 18 to 21 years, were prospectively enrolled. Focused echocardiography was performed by a board-certified sports medicine physician and a medical student, followed by comprehensive echocardiography within 2 weeks by a cardiac sonographer. A left parasternal long-axis view was acquired to measure the aortic root diameter at the sinuses of Valsalva. Intraclass correlation coefficients (ICCs) were used to assess inter-rater reliability compared to a reference standard and intra-rater reliability of repeated measurements obtained by the sports medicine physician and medical student.
  
  
  RESULTS
  The ICCs between the sports medicine physician and cardiac sonographer and between the medical student and cardiac sonographer were strong: 0.80 and 0.76, respectively. Across all 3 readers, the ICC was 0.89, indicating strong inter-rater reliability and concordance. The ICC for the 2 measurements taken by the sports medicine physician for each athlete was 0.75, indicating strong intra-rater reliability. The medical student had moderate intra-rater reliability, with an ICC of 0.59.
  
  
  CONCLUSIONS
  Sports medicine physicians are able to obtain measurements of the aortic root by focused echocardiography that are consistent with those obtained by a cardiac sonographer. Focused physician-performed echocardiography may serve as a promising technique for detecting aortic root dilatation and may contribute in this manner to preparticipation cardiovascular screening for athletes.
authors.affiliation: Stanford Sports Medicine Center, 341 Galvez St, Stanford, CA 94305 USA. eugene.yim@post.harvard.edu.
authors.forename: Eugene S
authors.initials: ES
authors.lastname: Yim
authors.forename: Daniel
authors.initials: D
authors.lastname: Kao
authors.forename: Edward F
authors.initials: EF
authors.lastname: Gillis
authors.forename: Frederick C
authors.initials: FC
authors.lastname: Basilico
authors.forename: Gianmichael D
authors.initials: GD
authors.lastname: Corrado
mesh_terms: D000293:Adolescent; D001018:Aortic Diseases / Q000000981:diagnostic imaging*; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging; D004452:Echocardiography / Q000379:methods*; D005240:Feasibility Studies; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013178:Sports Medicine / Q000379:methods*; D055815:Young Adult
keywords: aortic root dilatation; athletes; echocardiography; preparticipation screening; sonography; sports medicine