Dr Corrado said that in the USA young athletes had physical examinations and personal and family history investigations, but 12-lead ECG was done only at the doctor's discretion. The American Heart Association previously assumed that ECG would not be cost-effective for screening because of low specificity[4].
"In fact, this is not the case," said Dr Corrado "The Italian screening method has proven to be more sensitive than the limited US protocol. ECG is abnormal in up to 95% of patients with hypertropic cardiomyopathy (HCM), which is the leading cause of sudden death in an athlete. ECG abnormalities have also been documented in the majority of athletes who died from other arrhythmogenic heart muscle diseases."
Comparisons between findings in Italy where ECG is used and research in the USA showed a similar prevalence of HCM in non-sport sudden cardiac death, but a significant difference 2% versus 24% in sports-related cardiovascular events.
"This suggests we have selectively reduced sports-related sudden death from HCM because our system, using ECG, identifies vulnerable young people," said Dr Corrado.
He said that a number of the conditions now being picked up by ECG had only recently been discovered, so diagnosis was increasing. Researchers would shortly be examining the impact on mortality of the increased detection of potentially lethal problems.
It was harder to detect premature hardening of the coronary arteries or abnormalities in the coronary artery in young competitors, he said, because baseline ECG signs of blood flow (ischaemic) problems
'"/>
Contact: Margaret Willson
m.willson@mwcommunications.org.uk
44-1-536-772-181
European Society of Cardiology
1-Feb-2005