Background: Pre-participation screening (PPS) of athletes aged over 35 years (master athletes, MA) is a major concern in Sports Cardiology. In this population, sports-related sudden cardiac death is rare but usually due to coronary atherosclerosis (CA). Coronary CT Angiography (CCTA) has changed the approach to diagnosis/management of CA, but its role in this context still needs to be assessed. Methods and results: We retrospectively examined 167 MA who underwent CCTA in our hospital since 2006, analyzing symptoms, stress-test ECG, cardiovascular risk profiles (SCORE) and CCTA findings. Among the whole enrolled population, 153 (91.6%) MA underwent CCTA for equivocal/positive stress-test ECG with/without symptoms, 13 (7.8%) just for clinical symptoms, 1 (0.6%) for the family history. The CCTA showed the presence of CA in 69 MA (41.3%), congenital coronary anomalies (anomalous origin or deep myocardial bridge) in 8 (4.8%), both in 7 (4.2%). A negative CCTA was observed in 83 MA (49.7%). The risk-SCORE (age, hypertension, hypercholesterolemia, smoking) was a good indicator for the presence of moderate/severe CA on CCTA. However,mild/moderate CAwas present in 17.8% ofMA clinically stratified at a low risk-SCORE. Conclusion:While coronary angiography ismore indicated in athletes with positive stress-test ECG and high clinical risk, the CCTA may be useful in the evaluation of MAwith an abnormal stress test ECG and/or clinical symptoms engaged in competitive sports with a high cardiovascular involvement. Age, gender, presence of symptoms and clinical risk-SCORE assessment may help sports physicians and cardiologists to decide whether to request a CCTA or not.

Gervasi, S., Palumbo, L., Cammarano, M., Orvieto, S., Di Rocco, A., Vestri, A., Marano, R., Savino, G., Bianco, M., Zeppilli, P., Palmieri, V., Coronary atherosclerosis in apparently healthy master athletes discovered during pre-PARTECIPATION screening. Role of coronary CT angiography (CCTA)., <<INTERNATIONAL JOURNAL OF CARDIOLOGY>>, 2019; 2019 (282:): 99-107. [doi:10.1016/j.ijcard.2018.11.099] [http://hdl.handle.net/10807/132042]

Coronary atherosclerosis in apparently healthy master athletes discovered during pre-PARTECIPATION screening. Role of coronary CT angiography (CCTA).

Cammarano, M;Orvieto, S;Marano, R;Savino, G;Bianco, M;Zeppilli, P;Palmieri, V.
2019

Abstract

Background: Pre-participation screening (PPS) of athletes aged over 35 years (master athletes, MA) is a major concern in Sports Cardiology. In this population, sports-related sudden cardiac death is rare but usually due to coronary atherosclerosis (CA). Coronary CT Angiography (CCTA) has changed the approach to diagnosis/management of CA, but its role in this context still needs to be assessed. Methods and results: We retrospectively examined 167 MA who underwent CCTA in our hospital since 2006, analyzing symptoms, stress-test ECG, cardiovascular risk profiles (SCORE) and CCTA findings. Among the whole enrolled population, 153 (91.6%) MA underwent CCTA for equivocal/positive stress-test ECG with/without symptoms, 13 (7.8%) just for clinical symptoms, 1 (0.6%) for the family history. The CCTA showed the presence of CA in 69 MA (41.3%), congenital coronary anomalies (anomalous origin or deep myocardial bridge) in 8 (4.8%), both in 7 (4.2%). A negative CCTA was observed in 83 MA (49.7%). The risk-SCORE (age, hypertension, hypercholesterolemia, smoking) was a good indicator for the presence of moderate/severe CA on CCTA. However,mild/moderate CAwas present in 17.8% ofMA clinically stratified at a low risk-SCORE. Conclusion:While coronary angiography ismore indicated in athletes with positive stress-test ECG and high clinical risk, the CCTA may be useful in the evaluation of MAwith an abnormal stress test ECG and/or clinical symptoms engaged in competitive sports with a high cardiovascular involvement. Age, gender, presence of symptoms and clinical risk-SCORE assessment may help sports physicians and cardiologists to decide whether to request a CCTA or not.
2019
Inglese
Gervasi, S., Palumbo, L., Cammarano, M., Orvieto, S., Di Rocco, A., Vestri, A., Marano, R., Savino, G., Bianco, M., Zeppilli, P., Palmieri, V., Coronary atherosclerosis in apparently healthy master athletes discovered during pre-PARTECIPATION screening. Role of coronary CT angiography (CCTA)., <<INTERNATIONAL JOURNAL OF CARDIOLOGY>>, 2019; 2019 (282:): 99-107. [doi:10.1016/j.ijcard.2018.11.099] [http://hdl.handle.net/10807/132042]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/132042
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