Possibilities of echocardiographic screening in athletes. Part 2. Structural changes of the heart

Objective: to assess the suitability of existing domestic and international recommendations and standards for the use of echocardiography as a screening technique for examining athletes with various diseases.Materials and methods: a meta‑analysis of 59 domestic and foreign literature sources based on the results of an echocardiographic examination of athletes was carried out. The indicators of 2647 male athletes aged 16 to 45 years old, playing for the national teams of the city of Moscow and having passed an in‑depth medical examination at the Sports Medicine Clinic, were studied.Results: screening echocardiography sufficiently reveals structural deviations of the heart of athletes from population norms, including congenital or acquired pathologies that cause both sudden death and general morbidity compared with a healthy population.Conclusion: in order to speed up and reduce the cost of the examination of athletes, it is appropriate to use the primary screening, and if necessary, an in‑depth examination. In this case, it is advisable to distinguish three diagnostic stages that determine the danger or admissibility of playing sports: (A) — the risk of developing complications, (B) — the presence of structural changes in the heart, and (C) — the appearance of clinical symptoms.