Finocchiaro, G;
Papadakis, M;
Robertus, J-L;
Dhutia, H;
Steriotis, A;
Tome, M;
Mellor, G;
Merghani, A;
Malhotra, A;
Behr, ER;
et al.
Finocchiaro, G; Papadakis, M; Robertus, J-L; Dhutia, H; Steriotis, A; Tome, M; Mellor, G; Merghani, A; Malhotra, A; Behr, ER; Sharma, S; Sheppard, MN
(2016)
Etiology of Sudden Death in Sports: Insights From a United Kingdom Regional Registry.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 67 (18).
pp. 2108-2115.
ISSN 0735-1097
https://doi.org/10.1016/j.jacc.2016.02.062
SGUL Authors: Sharma, Sanjay
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Abstract
Background: Accurate knowledge of causes of sudden cardiac death (SCD) in athletes and its precipitating factors is necessary to establish preventative strategies. Objectives: This study investigated causes of SCD and their association with intensive physical activity in a large cohort of athletes. Methods: Between 1994 and 2014, 357 consecutive cases of athletes who died suddenly (mean 29 ± 11 years of age, 92% males, 76% Caucasian, 69% competitive) were referred to our cardiac pathology center. All subjects underwent detailed post-mortem evaluation, including histological analysis by an expert cardiac pathologist. Clinical information was obtained from referring coroners. Results: Sudden arrhythmic death syndrome (SADS) was the most prevalent cause of death (n = 149 [42%]). Myocardial disease was detected in 40% of cases, including idiopathic left ventricular hypertrophy (LVH) and/or fibrosis (n = 59, 16%); arrhythmogenic right ventricular cardiomyopathy (ARVC) (13%); and hypertrophic cardiomyopathy (HCM) (6%). Coronary artery anomalies occurred in 5% of cases. SADS and coronary artery anomalies affected predominantly young athletes (≤ 35 years of age), whereas myocardial disease was more common in older individuals. SCD during intense exertion occurred in 61% of cases; ARVC and left ventricular fibrosis most strongly predicted SCD during exertion. Conclusions: Conditions predisposing to SCD in sports demonstrate a significant age predilection. The strong association of ARVC and left ventricular fibrosis with exercise-induced SCD reinforces the need for early detection and abstinence from intense exercise. However, almost 40% of athletes die at rest, highlighting the need for complementary preventive strategies.
Item Type: | Article | ||||||||
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Additional Information: | © 2016. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ | ||||||||
Keywords: | Cardiovascular System & Hematology, 1102 Cardiovascular Medicine And Haematology, 1117 Public Health And Health Services | ||||||||
SGUL Research Institute / Research Centre: | Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) > Cardiac (INCCCA) |
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Journal or Publication Title: | JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | ||||||||
ISSN: | 0735-1097 | ||||||||
Dates: |
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Publisher License: | Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0 | ||||||||
URI: | https://openaccess.sgul.ac.uk/id/eprint/107898 | ||||||||
Publisher's version: | https://doi.org/10.1016/j.jacc.2016.02.062 |
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