title: Usefulness of echocardiography in preparticipation screening of competitive athletes.
abstract: OBJECTIVE
  Despite the established diagnostic value of the electrocardiogram in preparticipation screening of athletes, some cardiac structural changes can be missed, particularly in early disease stages. The aim of this study was to evaluate the prevalence of cardiac structural changes via the systematic use of echocardiography in preparticipation screening of competitive athletes.
  
  
  METHODS
  Professional athletes or participants in a competitive athletic program underwent a screening that included family and personal medical history, physical examination, electrocardiography, exercise testing, and Doppler echocardiography.
  
  
  RESULTS
  A total of 2688 athletes (67% men; mean age [standard deviation], 21 [10] years) were included. Most of the echocardiographic evaluations (92.5%) were normal and only 203 (7.5%) showed changes; the most frequent change was left ventricular hypertrophy, seen in 50 athletes (1.8%). Cessation of athletic activity was indicated in 4 athletes (0.14%): 2 for hypertrophic cardiomyopathy (electrocardiography had shown changes that did not meet diagnostic criteria), 1 pectus excavatum with compression of the right ventricle, and 1 significant pulmonary valve stenosis; the rest of the changes did not entail cessation of athletic activity and only indicated periodic monitoring.
  
  
  CONCLUSIONS
  Although rare, some cardiac structural changes can be missed on physical examination and electrocardiography; in contrast, they are easily recognized with echocardiography. These findings suggest the use of echocardiography in at least the first preparticipation screening of competitive athletes to improve the effectiveness of programs aimed at preventing sudden death in athletes.
authors.affiliation: Grup de Treball Cardiologia Esportiva, Institut del Tòrax, Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Grazioli
authors.affiliation: Grup de Treball Cardiologia Esportiva, Institut del Tòrax, Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Merino
authors.affiliation: Grup de Treball Cardiologia Esportiva, Institut del Tòrax, Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: Montserrat
authors.affiliation: Grup de Treball Cardiologia Esportiva, Institut del Tòrax, Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.
authors.forename: Bàrbara
authors.initials: B
authors.lastname: Vidal
authors.affiliation: Grup de Treball Cardiologia Esportiva, Institut del Tòrax, Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.
authors.forename: Manel
authors.initials: M
authors.lastname: Azqueta
authors.affiliation: Grup de Treball Cardiologia Esportiva, Institut del Tòrax, Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.
authors.forename: Carles
authors.initials: C
authors.lastname: Pare
authors.affiliation: Servicio de Cardiología, Hospital Sant Joan de Déu, Universitat de Barcelona, Sant Joan Despí, Barcelona, Spain.
authors.forename: Georgia
authors.initials: G
authors.lastname: Sarquella-Brugada
authors.affiliation: Servei Médic, Futbol Club Barcelona, Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Yangüas
authors.affiliation: Servei Médic, Futbol Club Barcelona, Barcelona, Spain.
authors.forename: Ramon
authors.initials: R
authors.lastname: Pi
authors.affiliation: Servei Médic, Futbol Club Barcelona, Barcelona, Spain; GIRSANE, Consorci Sanitari de Terrassa-Centre d'Alt Rendiment, Sant Cugat del Vallès, Barcelona, Spain.
authors.forename: Lluis
authors.initials: L
authors.lastname: Til
authors.affiliation: Área de Medicina, Consell Català de l'Esport, Generalitat de Catalunya, Barcelona, Spain.
authors.forename: Jaume
authors.initials: J
authors.lastname: Escoda
authors.affiliation: Grup de Treball Cardiologia Esportiva, Institut del Tòrax, Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Brugada
authors.affiliation: Grup de Treball Cardiologia Esportiva, Institut del Tòrax, Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain. Electronic address: msitges@clinic.ub.es.
authors.forename: Marta
authors.initials: M
authors.lastname: Sitges
mesh_terms: D000293:Adolescent; D000328:Adult; D004452:Echocardiography; D005260:Female; D006321:Heart / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D013177:Sports / Q000502:physiology; D055815:Young Adult
keywords: Athletes; Atletas; Deporte; Echocardiography; Ecocardiografía; Muerte súbita; Preparticipation screening; Revisión preparticipativa; Sport; Sudden death