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Comparison of three current sets of electrocardiographic interpretation criteria for use in screening athletes

机译：当前用于筛选运动员的三套心电图解释标准的比较

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摘要

Background An increasing number of sporting bodies report unacceptably high levels of false-positive ECGs when undertaking pre-participation cardiac screening. To address this issue, modified ECG interpretation criteria have become available for use within athletes. Objective This study assessed the accuracy of the new 2014 'Refined Criteria' against the 2013 Seattle Criteria and the 2010 European Society of Cardiology (ESC) recommendations in a cohort of Arabic, black and Caucasian athletes. Methods 2491 male athletes (1367 Arabic, 748 black and 376 Caucasian) undertook pre-participation screening including a 12-lead ECG, with further investigation(s) upon indication. Results Ten athletes (0.4%) were identified with cardiac pathology; seven with hypertrophic cardiomyopathy (HCM; five black and two Arabic) and three Arabs with Wolff-Parkinson-White syndrome (WPW). All three ECG criteria were 100% sensitive identifying all cases of HCM and WPW. The 2014 Refined Criteria reduced (p＜0.0001) the prevalence of an abnormal ECG to 5.3% vs 11.6% (Seattle Criteria) and 22.3% (2010 ESC recommendations). The 2014 Refined Criteria significantly (p＜0.0001) improved specificity (94.0%) across all ethnicities compared with the Seattle Criteria (87.5%) and ESC recommendations (76.6%). Black athletes continue to present a higher prevalence (p＜0.0001) of abnormal ECGs compared with Arabic and Caucasian athletes (10% vs 3.6% and 2.1%). Conclusions The 2014 Refined Criteria for athlete ECG interpretation outperformed both the 2013 Seattle Criteria and the 2010 ESC recommendations by significantly reducing the number of false-positive ECGs in Arabic, black and Caucasian athletes while maintaining 100% sensitivity for serious cardiac pathologies.
机译：背景技术越来越多的体育机构在进行参与前的心脏筛查时报告假阳性心电图水平过高。为了解决这个问题，已修改的ECG解释标准已可供运动员使用。目的这项研究针对一组2013年西雅图标准和2010年欧洲心脏病学会（ESC）建议的一组阿拉伯，黑人和白种人运动员，评估了新的2014年“精练标准”的准确性。方法对2491名男性运动员（1367名阿拉伯运动员，748名黑人和376名白种人）进行了包括12导联心电图在内的参与前筛查，并根据适应症进行了进一步调查。结果确认有10名运动员（占0.4％）患有心脏病理学检查；七名患有肥厚型心肌病（HCM；五名黑人和两名阿拉伯人），三名患有Wolff-Parkinson-White综合征（WPW）的阿拉伯人。所有这三个ECG标准对识别HCM和WPW的所有病例都是100％敏感的。 2014年完善标准将异常心电图的患病率降低了（p ＜0.0001），分别为5.3％和11.6％（西雅图标准）和22.3％（2010 ESC建议）。与西雅图准则（87.5％）和ESC建议（76.6％）相比，2014年“精细准则”在所有种族中的特异性（94.0％）显着提高（p ＜0.0001）。与阿拉伯和白种人运动员相比，黑人运动员继续表现出较高的异常心电图患病率（p ＜0.0001）（10％比3.6％和2.1％）。结论2014年运动员心电图解释细化标准优于2013年西雅图标准和2010年ESC建议，大大减少了阿拉伯，黑人和白种人运动员假阳性心电图的数量，同时对严重的心脏疾病保持100％的敏感性。

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  • 来源
    《Heart》 |2015年第5期|384-390|共7页
  • 作者

    Nathan R Riding; Nabeel Sheikh; Carmen Adamuz; Victoria Watt; Abdulaziz Farooq; Gregory P Whyte; Keith P George; Jonathan A Drezner; Sanjay Sharma; Mathew G Wilson;

  • 作者单位

    Athlete Health and Performance Research Centre, ASPETAR, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar,Research Institute for Sport and Exercise Science, Liverpool John Moores University, UK;

    Department of Cardiovascular Sciences, St Georges University of London, UK;

    Department of Sports Medicine, ASPETAR, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar;

    Department of Sports Medicine, ASPETAR, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar;

    Athlete Health and Performance Research Centre, ASPETAR, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar;

    Research Institute for Sport and Exercise Science, Liverpool John Moores University, UK;

    Research Institute for Sport and Exercise Science, Liverpool John Moores University, UK;

    Department of Family Medicine, University of Washington, Seattle, Washington USA;

    Department of Cardiovascular Sciences, St Georges University of London, UK;

    Athlete Health and Performance Research Centre, ASPETAR, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar,Department of Sports Medicine, ASPETAR, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar,ASPETAR, Qatar Orthopaedic and Sports Medicine Hospital, PO Box 29222, Doha, Qatar;

  • 收录信息 美国《科学引文索引》(SCI);美国《化学文摘》(CA);
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