Tamización cardíaca para prevención de muerte súbita en atletas de representación de la Universidad de Antioquia, Medellín, Colombia

José David García-Ortiz

doi:10.17533/udea.iatreia.v30n3a02

Autores/as

José David García-Ortiz Universidad de Antioquia https://orcid.org/0000-0002-1825-0097

DOI:

https://doi.org/10.17533/udea.iatreia.v30n3a02

Palabras clave:

electrocardiograma, examen físico, muerte cardíaca súbita, tamización

Resumen

La participación activa en el deporte es benéfica para la salud y el bienestar de los individuos, pero, inherente a su práctica, hay un incremento en el riesgo de sufrir diversas lesiones y muerte cardíaca súbita; por esto, el Comité Olímpico Internacional recomienda a los atletas someterse a una tamización cardiovascular antes de participar en el deporte. El objetivo de este estudio fue describir la prevalencia de trastornos cardiovasculares subyacentes que predisponen a la muerte súbita en una muestra de 80 atletas de representación de la Universidad de Antioquia, de disciplinas deportivas con componente dinámico entre moderado y alto; se les aplicó el protocolo de tamización cardiovascular de la Sociedad Europea de Cardiología, que consta de un cuestionario para conocer los antecedentes familiares y personales de salud, una evaluación física cardiovascular y una electrocardiografía de 12 derivaciones. Se encontró una prevalencia del 3,8 % de atletas con riesgo cardiovascular y 76,3 % tenían hallazgos compatibles con el “corazón del atleta”, por lo que se puede concluir que la tamización con electrocardiografía es una estrategia clínica válida para la detección precoz de atletas jóvenes con riesgo cardiovascular para muerte cardíaca súbita.

|Resumen

= 579 veces | PDF

= 273 veces|

Descargas

Los datos de descargas todavía no están disponibles.

Biografía del autor/a

José David García-Ortiz, Universidad de Antioquia

Médico cirujano, Universidad del Cauca, Popayán, Colombia. Especialista en Medicina aplicada a la actividad física y al deporte. Docente de cátedra del Instituto de Educación Física, Universidad de Antioquia, Medellín, Colombia.

Citas

(1.) Harmon KG, Drezner JA, Wilson MG, Sharma S. Incidence of sudden cardiac death in athletes: a state-of- the-art review. Heart. 2014 Aug;100(16):1227-34. DOI 10.1136/heartjnl-2014-093872.rep.

(2.) Maron BJ, Thompson PD, Ackerman MJ, Balady G, Berger S, Cohen D, et al. Recommendations and considerations related to preparticipation screening for cardiovascular abnormalities in competitive athletes: 2007 update: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism: endorsed by the American College of Cardiology Foundation. Circulation. 2007 Mar;115(12):1643-455.

(3.) Holst AG, Winkel BG, Theilade J, Kristensen IB, Thomsen JL, Ottesen GL, et al. Incidence and etiology of sports-related sudden cardiac death in Denmark- -implications for preparticipation screening. Heart Rhythm. 2010 Oct;7(10):1365-71. DOI 10.1016/j.hr- thm.2010.05.021.

(4.) Maron BJ. Hypertrophic cardiomyopathy and other causes of sudden cardiac death in young competitive athletes, with considerations for preparticipation screening and criteria for disqualification. Cardiol Clin. 2007 Aug;25(3):399-414, vi.

(5.) Alattar A, Ghani S, Mahdy N, Hussain H, Maffulli N. Pre-participation musculoskeletal and cardiac screening of male athletes in the United arab emirates. Transl Med UniSa. 2014 Apr;9:43-9.

(6.) Bille K, Figueiras D, Schamasch P, Kappenberger L, Brenner JI, Meijboom FJ, et al. Sudden cardiac death in athletes: the Lausanne Recommendations. Eur J Cardiovasc Prev Rehabil. 2006 Dec;13(6):859-75.

(7.) Magalski A, McCoy M, Zabel M, Magee LM, Goeke J, Main ML, et al. Cardiovascular screening with elec- trocardiography and echocardiography in collegiate athletes. Am J Med. 2011 Jun;124(6):511-8. DOI 10.1016/j.amjmed.2011.01.009.

(8.) Sofi F, Capalbo A, Pucci N, Giuliattini J, Condino F, Alessandri F, et al. Cardiovascular evaluation, including resting and exercise electrocardiography, before participation in competitive sports: cross sectional study. BMJ. 2008 Jul;337:a346. DOI 10.1136/bmj.a346.

(9.) Asif IM, Drezner JA. Sudden cardiac death and pre- participation screening: the debate continues-in support of electrocardiogram-inclusive preparticipation screening. Prog Cardiovasc Dis. 2012 Mar- Apr;54(5):445-50. DOI 10.1016/j.pcad.2012.01.001.

(10.) Drezner JA, Ackerman MJ, Anderson J, Ashley E, Asplund CA, Baggish AL, et al. Electrocardiographic interpretation in athletes: the ‘Seattle criteria’. Br J Sports Med. 2013 Feb;47(3):122-4. DOI 10.1136/bj-sports-2012-092067.

(11.) Stein R, Malhotra A. T wave inversions in athletes: a variety of scenarios. J Electrocardiol. 2015 May-Jun;48(3):415-9. DOI 10.1016/j.jelectro-card.2015.01.011.

(12.) Pelliccia A, Quattrini FM. Clinical significance of J-wave in elite athletes. J Electrocardiol. 2015 May-Jun;48(3):385-9. DOI 10.1016/j.jelectro-card.2015.03.012.

(13.) Maron BJ, Doerer JJ, Haas TS, Tierney DM, Mueller FO. Sudden deaths in young competitive athletes: analysis of 1866 deaths in the United States, 1980-2006. Circulation. 2009 Mar;119(8):1085-92. DOI 10.1161/CIRCULATIONAHA.108.804617.

(14.) Pigozzi F, Rizzo M. Sudden death in competitive athletes. Clin Sports Med. 2008 Jan;27(1):153-81, ix. DOI 10.1016/j.csm.2007.09.004.

(15.) Macfarlane PW, Clark EN, Heng JS. J wave patterns- -morphology, prevalence and nomenclature. J Electrocardiol. 2013 Nov-Dec;46(6):505-9. DOI 10.1016/j.jelectrocard.2013.08.013.

(16.) Kalla H, Yan GX, Marinchak R. Ventricular fibrillation in a patient with prominent J (Osborn) waves and ST segment elevation in the inferior electrocardiogra- phic leads: a Brugada syndrome variant? J Cardiovasc Electrophysiol. 2000 Jan;11(1):95-8.

(17.) Gussak I, Antzelevitch C. Early repolarization syndrome: clinical characteristics and possible cellular and ionic mechanisms. J Electrocardiol. 2000 Oct;33(4):299-309.

(18.) Haïssaguerre M, Derval N, Sacher F, Jesel L, Deisenhofer I, de Roy L, et al. Sudden cardiac arrest associated with early repolarization. N Engl J Med. 2008 May;358(19):2016-23. DOI 10.1056/NEJMoa071968.

(19.) Muramoto D, Yong CM, Singh N, Aggarwal S, Pe- rez M, Ashley E, et al. Patterns and prognosis of all components of the J-wave pattern in multiethnic athletes and ambulatory patients. Am Heart J. 2014 Feb;167(2):259-66. DOI 10.1016/j.ahj.2013.10.027.

(20.) Noseworthy PA, Baggish AL. The prevalence and clinical significance of J wave patterns in athletes. J Electrocardiol. 2013 Sep-Oct;46(5):424-6. DOI 10.1016/j. jelectrocard.2013.06.021.

(21.) Munger TM, Packer DL, Hammill SC, Feldman BJ, Bailey KR, Ballard DJ, et al. A population study of the natural history of Wolff-Parkinson-White syndrome in Olmsted County, Minnesota, 1953-1989. Circulation. 1993 Mar;87(3):866-73.

(22.) Hiss RG, Lamb LE. Electrocardiographic findings in 122,043 individuals. Circulation. 1962 Jun;25:947-61.

(23.) Ceresnak SR, Dubin AM. Wolff-Parkinson-White syndrome (WPW) and athletes: Darwin at play? J Electrocardiol. 2015 May-Jun;48(3):356-61. DOI 10.1016/j.jelectrocard.2014.12.019.

(24.) Lampert R. Evaluation and management of arrhythmia in the athletic patient. Prog Cardiovasc Dis. 2012 Mar-Apr;54(5):423-31-DOI 10.1016/j.pcad.2012.01.002.

(25.) Biffi A, Pelliccia A, Verdile L, Fernando F, Spataro A, Caselli S, et al. Long-term clinical significance of frequent and complex ventricular tachyarrhythmias in trained athletes. J Am Coll Cardiol. 2002 Aug;40(3):446-52.

(26.) Harmon KG, Zigman M, Drezner JA. The effectiveness of screening history, physical exam, and ECG to detect potentially lethal cardiac disorders in athletes: a systematic review/metaanalysis. J Electrocardiol. 2015 May-Jun;48(3):329-38. DOI 10.1016/j.jelectro-card.2015.02.001.

(27.) Corrado D, Basso C, Pavei A, Michieli P, Schiavon M, Thiene G. Trends in sudden cardiovascular death in young competitive athletes after implementation of a preparticipation screening program. JAMA. 2006 Oct;296(13):1593-601.

(28.) Mont L, Pelliccia A, Sharma S, Biffi A, Borjesson M, Brugada Terradellas J, et al. Pre-participation cardiovascular evaluation for athletic participants to prevent sudden death: Position paper from the EHRA and the EACPR, branches of the ESC. Endorsed by APHRS, HRS, and SOLAECE. Eur J Prev Cardiol. 2017 Jan;24(1):41-69.

(29.) Maron BJ, Pelliccia A. The heart of trained athletes: cardiac remodeling and the risks of sports, including sudden death. Circulation. 2006 Oct;114(15):1633-44.

(30.) Chaitman BR. An electrocardiogram should not be included in routine preparticipation screening of young athletes. Circulation. 2007 Nov;116(22):2610-4; discussion 2615.

(31.) Zorzi A, ElMaghawry M, Corrado D. Evolving interpretation of the athlete’s electrocardiogram: from European Society of Cardiology and Stanford criteria, to Seattle criteria and beyond. J Electrocardiol. 2015 May-Jun;48(3):283-91. DOI 10.1016/j.jelectro-card.2015.01.007.

(32.) Sheikh N, Papadakis M, Ghani S, Zaidi A, Gati S, Adami PE, et al. Comparison of electrocardiographic criteria for the detection of cardiac abnormalities in elite black and white athletes. Circulation. 2014 Apr;129(16):1637-49. DOI 10.1161/CIRCULATIONA-HA.113.006179.

(33.) Riding NR, Sheikh N, Adamuz C, Watt V, Farooq A, Whyte GP, et al. Comparison of three current sets of electrocardiographic interpretation criteria for use in screening athletes. Heart. 2015 Mar;101(5):384-90. DOI 10.1136/heartjnl-2014-306437.

(34.) Machado M, Vaz Silva M. Benign and pathologi- cal electrocardiographic changes in athletes. Rev Port Cardiol. 2015 Dec;34(12):753-70. DOI 10.1016/j.repc.2015.07.007.

(35.) Chandra N, Bastiaenen R, Papadakis M, Sharma S. Sudden cardiac death in young athletes: practical challenges and diagnostic dilemmas. J Am Coll Cardiol. 2013 Mar;61(10):1027-40. DOI 10.1016/j. jacc.2012.08.1032.

(36.) Corrado D, Basso C, Rizzoli G, Schiavon M, Thiene G. Does sports activity enhance the risk of sudden death in adolescents and young adults? J Am Coll Cardiol. 2003 Dec;42(11):1959-63.

(37.) Corrado D, Pelliccia A, Bjørnstad HH, Vanhees L, Biffi A, Borjesson M, et al. Cardiovascular pre-participation screening of young competitive athletes for prevention of sudden death: proposal for a common European protocol. Eur Heart J. 2005;26(5):516-24. DOI 10.1093/eurheartj/ehi108.

(38.) Seckeler MD, Hoke TR. The worldwide epidemiology of acute rheumatic fever and rheumatic heart disease. Clin Epidemiol. 2011 Feb;3:67-84. DOI 10.2147/CLEP.S12977.