Return to play with hypertrophic cardiomyopathy: are we moving too fast? A critical review.

Szczegóły
Abstrakt

Tytuł:: Return to play with hypertrophic cardiomyopathy: are we moving too fast? A critical review.
Autorzy:: Drezner JA; Center for Sports Cardiology, University of Washington, Seattle, Washington, USA .
Malhotra A; Division of Cardiovascular Sciences, University of Manchester, Manchester, UK.
Prutkin JM; Department of Internal Medicine, Division of Cardiology, University of Washington, Seattle, Washington, USA.
Papadakis M; Cardiology, Clinical Academic Group, St George's, University of London, London, UK.
Harmon KG; Center for Sports Cardiology, University of Washington, Seattle, Washington, USA.
Asif IM; Center for Health Promotion, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Owens DS; Department of Internal Medicine, Division of Cardiology, University of Washington, Seattle, Washington, USA.
Marek JC; Cardiology, Advocate Heart Institute, Downers Grove, Illinois, USA.
Sharma S; Cardiology, Clinical Academic Group, St George's, University of London, London, UK.
Źródło:: British journal of sports medicine [Br J Sports Med] 2021 Sep; Vol. 55 (18), pp. 1041-1047. Date of Electronic Publication: 2021 Jan 20.
Typ publikacji:: Journal Article; Review
Język:: English
Imprint Name(s):: Publication: London : BMJ Publishing Group
Original Publication: Loughborough, Eng.
MeSH Terms:: Cardiomyopathy, Hypertrophic*/diagnosis
Return to Sport*
Sports*
Adolescent ; Athletes ; Death, Sudden, Cardiac/prevention & control ; Decision Making ; Humans ; Male ; Young Adult
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Contributed Indexing:: Keywords: cardiovascular; death; heart disease; prevention; sport
Entry Date(s):: Date Created: 20210121 Date Completed: 20211018 Latest Revision: 20211018
Update Code:: 20240105
PubMed Central ID:: PMC8408577
DOI:: 10.1136/bjsports-2020-102921
PMID:: 33472848
: Czasopismo naukowe

The diagnosis of a potentially lethal cardiovascular disease in a young athlete presents a complex dilemma regarding athlete safety, patient autonomy, team or institutional risk tolerance and medical decision-making. Consensus cardiology recommendations previously supported the 'blanket' disqualification of athletes with hypertrophic cardiomyopathy (HCM) from competitive sport. More recently, epidemiological studies examining the relative contribution of HCM as a cause of sudden cardiac death (SCD) in young athletes and reports from small cohorts of older athletes with HCM that continue to exercise have fueled debate whether it is safe to play with HCM. Shared decision-making is endorsed within the sports cardiology community in which athletes can make an informed decision about treatment options and potentially elect to continue competitive sports participation. This review critically examines the available evidence relevant to sports eligibility decisions in young athletes diagnosed with HCM. Histopathologically, HCM presents an unstable myocardial substrate that is vulnerable to ventricular tachyarrhythmias during exercise. Studies support that young age and intense competitive sports are risk factors for SCD in patients with HCM. We provide an estimate of annual mortality based on our understanding of disease prevalence and the incidence of HCM-related SCD in different athlete populations. Adolescent and young adult male athletes and athletes participating in a higher risk sport such as basketball, soccer and American football exhibit a greater risk. This review explores the potential harms and benefits of sports disqualification in athletes with HCM and details the challenges and limitations of shared decision-making when all parties may not agree.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

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