加强运动健将心血管筛查:运动应激超声心动图的作用。

IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Valentina Pescatore, Mattia Grassi, Stefano Palermi, Marco Vecchiato, Erica Brugin, Silvia Compagno, Carlo Zanella, Salvatore Saccà, Antonello D'Andrea, Giulia Quinto, Andrea Ermolao, Franco Giada
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引用次数: 0

摘要

背景:即使在看起来更健康的人群中,心血管(CV)疾病也是一个重要的风险,比如运动员,由于他们的高龄和高强度的身体活动,他们面临着独特的CV挑战。运动应激超声心动图(ESE)已成为一种有价值的诊断工具,用于检测运动诱发的冠状动脉疾病(CAD),通过整合超声心动图成像,它比传统的运动应激试验(EST)具有优势。本文旨在评估ESE在参与前筛查(PPS) EST中表现出运动诱发改变的运动员中检测CAD的诊断价值和有效性。方法:本回顾性研究分析了521名运动员(35岁及以上),这些运动员于2020年9月至2023年8月在意大利威尼斯Noale医院接受了包括EST在内的年度CV评估,作为其PPS的一部分。在EST上显示疑似CAD的运动诱导改变的参与者使用ESE进一步评估。结果:在筛选的521名运动员中,58名(11.1%)在EST期间表现出可疑的CAD改变。ESE进一步确定了13名有壁运动异常(WMA)的运动员,其中10名随后被诊断为严重的CAD并接受了适当的干预。ESE阳性预测值为0.77。相比之下,WMA运动员的CV风险评分明显较高。在43.9个月的随访中,无重大不良CV事件(MACE)报告。结论:ESE是优秀运动员有效的三线诊断工具,在识别显著的CAD方面具有很高的诊断率。将其整合到优秀运动员的常规心血管筛查中,可以增强对潜在病理的发现,从而可能导致及时和挽救生命的干预措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Enhancing cardiovascular screening in master athletes: the role of exercise stress echocardiography.

Background: Cardiovascular (CV) disease is a significant risk even among seemingly healthier populations like master athletes, who face unique CV challenges due to their advanced age and high-intensity physical activities. Exercise stress echocardiography (ESE) has emerged as a valuable diagnostic tool to detect exercise-induced coronary artery disease (CAD), offering advantages over traditional exercise stress testing (EST) by integrating echocardiographic imaging. This article aimed to assess the diagnostic value and efficacy of ESE for detecting CAD in master athletes who exhibit exercise-induced alterations during pre-participation screening (PPS) EST.

Methods: This retrospective study analyzed 521 master athletes (aged 35 years and older) who underwent annual CV assessments including EST as part of their PPS at Noale Hospital, Venice, Italy, from September 2020 to August 2023. Participants who showed exercise-induced alterations suspicious for CAD on EST were further evaluated using ESE.

Results: Of the 521 athletes screened, 58 (11.1%) exhibited suspicious alterations for CAD during EST. ESE further identified 13 athletes with wall motion abnormalities (WMA), of whom 10 were subsequently diagnosed with critical CAD and received appropriate interventions. The positive predictive value of ESE was 0.77. Comparatively, athletes with WMA had significantly higher CV risk scores. No major adverse CV events (MACE) were reported during the 43.9-month follow-up.

Conclusions: ESE is an effective third-line diagnostic tool in master athletes, demonstrating a high diagnostic yield for identifying significant CAD. Its integration into routine CV screening for master athletes can enhance the detection of underlying pathologies, potentially leading to timely and life-saving interventions.

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来源期刊
Minerva cardiology and angiology
Minerva cardiology and angiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
2.60
自引率
18.80%
发文量
118
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