Detection of Cardiac Abnormalities in Elite Black and White Athletes

Abstract

Sports are “hot.” The average cost of a 30-second advertisement at the 2014 Super Bowl was $4 000 000,1 and millions of fans worldwide spent much of their February 2014 watching the Sochi Winter Olympics and its advertising. Sports cardiology is also hot. The American College of Cardiology in 2011 established a section dedicated to sports and exercise cardiology, and now there are several sports cardiology sessions during its annual meeting. Additional heat in sports cardiology comes from for the controversy regarding whether the screening of young athletes for sports participation requires an ECG. European colleagues favor ECG screening primarily because of a 2006 observational study demonstrating reduced cardiovascular deaths among screened athletes and no decrease in a nonathletic comparison population.2 At least 2 subsequent articles3,4 failed to corroborate a reduction in events with ECG screening. Article see p 1637 Scientific debate is unlikely when the evidence and its interpretation are clear. As usual, this controversy is among experts with different opinions on the quality of the data on how to protect athletes. Most evidence suggest that the annual risk of a sports-related cardiovascular death is 1 in 200 0005 to 900 0006 participants per year, but 1 study in an earlier edition of Circulation found a yearly death rate of 1 per 3100 National Collegiate Athletic Association Division I male basketball players or 1 death per 800 athletes over a college career,7 a figure high enough, if true, to question the value of the sport. There is also debate as to whether finding asymptomatic but potentially life-threatening conditions will actually save lives and not simply subject athletes to more tests resulting …