Heart Tests May Cut Deaths in Competitive Athletes, Study Says

Screening programs that monitor the heart's activity during exercise detect more athletes at risk of sudden cardiac death than other tests and should be more widely used to save lives, a British Medical Journal study found, reported The Bloomberg.

In research involving 30,065 athletes, electrocardiograms taken during exercise showed that 4.9 percent of participants had abnormal heart activity. That compares with only 1.2 percent identified using the same test during a rest period, according to researchers led by Francesco Sofi at the University of Florence's Institute of Sports Medicine.

One young competitive athlete dies every three days from an unrecognized cardiovascular disorder in the U.S. alone, the researchers said. The problem claimed the lives of Cameroonian soccer player Marc-Vivien Foe, 28, in 2003 and 22-year-old Sevilla soccer player Antonio Puerta in 2007. The researchers call for electrocardiograms, also called ECGs, to be added to screening programs for all people taking part in competitive sports.

``Adding electrocardiography to the screening process will detect more athletes with silent cardiovascular disorders at risk of sudden death,'' Jonathan Drezner, a professor at the University of Washington, said in an accompanying editorial.

U.S. and European authorities now recommend a pre- participation evaluation that includes taking a detailed patient and family history as well as a physical examination.

For the last 25 years, Italian athletes have also had to produce two ECGs, one at rest and one during exercise, in order to compete. The usefulness of these screening programs, which cost about 40 euros ($64) and are performed on all athletes over the age of five who compete in official sport in Italy, has been debated, Sofi said.

Of the 30,065 athletes tested, 159 were disqualified from participating in sport because of heart problems identified through the two ECG tests. Of these, only six people would have been identified through history and physical examination alone. That means 19 out of 20 would have been missed, the researchers said. Eight in ten patients would have missed if the patients had only had a resting ECG, the scientists said.

The age of people with problems found only during the exercise ECG was significantly higher -- 30.9 years old compared with 24.9 years old -- than those who had normal test results, the study found.

Participants in the study took part in more than 30 different types of sport. Soccer and volleyball were the most commonly played, the researchers said.

Work led by the University of Padua Medical School's Domenico Corrado in 2006 reported ``a sharp decrease in annual incidence of sudden cardiac deaths.'' The reduction was from 3.6 to 0.4 deaths per 100,000 a year over the 25 years Italy has had the screening program, Sofi wrote in an e-mail yesterday.

A study published in January in the New England Journal of Medicine found 6 percent of athletes in a 22-year study had ECG results which suggested heart problems. The research raised concerns that doctors often ignore ECG results taken after or during vigorous exercise.