[Race against sudden death : the benefits of pre-participation cardiovascular screening].

Revue medicale de Liege Pub Date : 2024-09-01
Camille Mathieu, Julien Tridetti, Cynthia Barbraud, Liliana Stefan, Jean-Manuel Herzet, Pierre Troisfontaines
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Abstract

Sudden death (SD) in young, apparently healthy athletes under 35 is an underestimated public health problem in Belgium. This is dramatically illustrated by the case of a 28-year old ultra-trail runner who suffered cardiac arrest during training, revealing an unrecognized cardiomyopathy. This highlights the importance of pre-participation cardiovascular screening in identifying such hidden conditions. The variety of causes of SD, mainly of cardiac origin, underlines the complexity of screening and the need to tailor it to the specific risks of each individual. The central issue in screening is the relevance of the resting 12-lead electrocardiogram (ECG). While some countries have adopted it with positive results, others continue to debate its systematic inclusion. Sudden death affects not only professional athletes, but also amateurs, who are often less medically monitored. The aim of cardiovascular screening is twofold: to identify young people at risk, while not unnecessarily limiting access to sport for those with no cardiac pathology. The effectiveness of the ECG is well recognized, but the implementation of such systematic screening in Belgium must take into account certain practical aspects.

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[与猝死赛跑:参赛前心血管筛查的益处]。
在比利时,35 岁以下表面健康的年轻运动员猝死(SD)是一个被低估的公共卫生问题。一名 28 岁的超级越野跑运动员在训练期间心脏骤停,暴露出未被发现的心肌病,这一病例充分说明了这一点。这凸显了参赛前心血管筛查对识别此类隐性疾病的重要性。导致 SD(主要是心源性 SD)的原因多种多样,这凸显了筛查的复杂性,以及根据每个人的具体风险量身定制筛查方案的必要性。筛查的核心问题是静息 12 导联心电图(ECG)的相关性。虽然一些国家采用了这一方法并取得了积极成果,但其他国家仍在就是否系统地纳入这一方法进行辩论。猝死不仅影响专业运动员,也影响业余运动员,因为他们通常较少受到医学监测。心血管疾病筛查的目的有两个:识别有风险的年轻人,同时又不会不必要地限制那些没有心脏疾病的人参加体育运动。心电图的有效性已得到公认,但在比利时实施这种系统筛查必须考虑到某些实际问题。
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