Cardiac Screening Findings and Referral Patterns in Male African-American Basketball Players: Analysis of the HeartBytes Registry.

Abstract

Sudden cardiac death (SCD) is the leading medical cause of death in young athletes. Male African American basketball players (MABP) appear to be at particularly high risk for SCD. Despite increasing screening and preventative efforts, the incidence of SCD remains elevated in this population. This study aimed to characterize cardiac screening findings, including symptoms, family history, physical exam, and electrocardiogram (ECG) abnormalities in MABP compared to other young athletes undergoing cardiac screening. We secondarily examined referral patterns based on screening results between the two groups. This retrospective study analyzed deidentified data from 8,303 individuals in the HeartBytes National Youth Cardiac Registry who underwent cardiac screening between 2015-2023, including 200 MABP. Screening components, ECG findings, and outcomes were compared between the MABP and non-MABP. Of 8,303 individuals screened, 200 MABP were identified. MABP were found to have higher rates of chest pain during exercise (10.0% vs. 4.8%, p<0.001), easily tiring with exercise (13.0% vs. 7.0%, p=0.003), and heart murmurs (8.9% vs. 4.4%, p=0.008) when compared to the rest of the population screened. ECG abnormalities, including T-wave inversions (4.0% vs. 0.8%, p<0.001), ST-segment depressions (0.5% vs. 0.05%, p=0.01), and nonspecific ST-T wave changes (2.0% vs. 0.4%, p<0.001), were more prevalent in MABP. However, positive screening rates leading to referral to a cardiologist were similar (3.5% vs. 3.2%, p=0.842) in MABP and the rest of the screened population. In conclusion, MABP exhibited higher rates of concerning cardiac screening findings compared to non-MABP, highlighting the need for further investigation into optimizing screening strategies and determining appropriate follow-up in this high-risk group.