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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; Jorstad, Harald T.

Pre-Participation Screenings Frequently Miss Occult Cardiovascular Conditions in Apparently Healthy Male Middle-Aged First-Time Marathon Runners

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  • Media type: E-Article
  • Title: Pre-Participation Screenings Frequently Miss Occult Cardiovascular Conditions in Apparently Healthy Male Middle-Aged First-Time Marathon Runners
  • Contributor: 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; Jorstad, Harald T.
  • Published: S. Karger AG, 2024
  • Published in: Cardiology (2024), Seite 1-9
  • Language: English
  • DOI: 10.1159/000536553
  • ISSN: 0008-6312; 1421-9751
  • Origination:
  • Footnote:
  • Description: <jats:p>&lt;b&gt;&lt;i&gt;Introduction:&lt;/i&gt;&lt;/b&gt; 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. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; 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. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; 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. &lt;b&gt;&lt;i&gt;Conclusion:&lt;/i&gt;&lt;/b&gt; 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. </jats:p>