The ECG of high-level junior soccer players: comparing the ESC vs. the Seattle criteria.

INTRODUCTION: Sudden cardiac death in young athletes is a devastating event. The screening and detection of potentially life-threatening cardiac pathology by ECG is difficult due to high numbers of false-positive results, especially in the very young. The Seattle ECG criteria (2013) were introduced to decrease false-positive results. We compared the Seattle ECG criteria with the European Society of Cardiology (ESC) ECG criteria of 2005 and 2010 for cardiac screening in high-level junior soccer players. METHODS: During the 2012-2013 season, all data from cardiovascular screenings performed on the youth division of two professional soccer clubs were collected. The total study population consisted of 193 male adolescent professional soccer players, aged 10-19 years. Five players dropped out of this study. RESULTS: Applying the ESC criteria of 2005 and 2010 to our population resulted in a total of 89 (47%) and 62 (33%) abnormal ECGs. When the Seattle ECG criteria were applied, the number of abnormal ECGs was 6 (3%). The reduction was mainly due to a reclassification of the long QT cut-off value and the exclusion of right atrial enlargement criteria. All ECG abnormalities using the Seattle criteria related to T-wave inversion criteria. CONCLUSION: The Seattle ECG criteria seem very promising for decreasing false-positive screening results for high-level junior soccer players.

Incidence and risk factors of running-related injuries during preparation for a 4-mile recreational running event.

OBJECTIVE: In this study, the incidence and the sex-specific predictors of running-related injury (RRI) among a group of recreational runners training for a 4-mile running event were determined and identified, respectively. DESIGN: Prospective cohort study. METHODS: Several potential risk factors were prospectively measured in 629 novice and recreational runners. They were observed during an 8-week training period for any running-related musculoskeletal injuries of the lower limbs and back. A running-related injury was defined as any musculoskeletal pain of the lower limb or back causing a restriction of running for at least 1 day. RESULTS: At least one RRI was reported by 25.9% of the runners during the 8-week observation period. The incidence of RRI was 30.1 (95% CI 25.4 to 34.7) per 1000 h of running exposure. Multivariate Cox regression showed that male participants were more prone to sustain a RRI than female participants (HR 1.4; 95% CI 1.0 to 2.0). No previous running experience was the most important risk factor in male (HR 2.6; 95% CI 1.2 to 5.5) and female (HR 2.1; 95% CI 1.2 to 3.7) participants. CONCLUSIONS: The incidence of running-related injuries in recreational runners preparing for a 4-mile running event is substantially high. Male and female participants have different risk profiles. Furthermore, the findings suggest that novice runners may benefit the most out of preventive interventions for RRI.

The Lausanne recommendations: a Dutch experience.

OBJECTIVE: This study presents the results of 28 months of preparticipation cardiovascular screening using the Lausanne recommendations, which include a personal and family history, physical examination and electrocardiogram (ECG). DESIGN: From January 2006 to April 2008 the data of the Lausanne screenings carried out at the University Centre of Sports Medicine in Groningen were collected. PARTICIPANTS: 825 cardiovascular screenings were performed of which 397 were excluded. Exclusion criteria were age under 12 or over 35 years, multiple screenings (only the first was included) and known cardiovascular disease. MAIN OUTCOME MEASURES: Negative screening result, (false) positive screening result, medical consumption and number needed to screen. RESULTS: A total of 371 (87%) athletes had a negative screening result. Fifty-five athletes (13%) underwent additional (stage 2) testing and seven (1.6%) further (stage 3) testing. Only 27 athletes (6.3%) were referred for additional testing based only on abnormalities of their ECG. Forty-seven athletes (11%) had a false-positive screening result. Ten athletes (2%) had a positive screening result and three (0.7%) were ultimately restricted from sports participation. Stage 2 medical consumption was 62%, 20% and 18% for one, two and three or more additional tests, respectively. Stage 3 medical consumption was 1.6%. The number of athletes needed to screen to find a single athlete with a potentially lethal cardiovascular disease was 143. CONCLUSION: This study found that when the Lausanne recommendations are implemented in The Netherlands, screening results resemble those found in previous studies. The number of athletes needed to screen to detect one athlete with a potentially lethal cardiovascular disease is also within an acceptable range.

[The value of preventive advice and examination focusing on cardiovascular events and injury for novice runners]. / De waarde van preventieve adviezen en keuringen bij beginnende hardlopers met het oog op cardiovasculaire gebeurtenissen en blessures.

Novice runners often seek advice from a physician about training responsibly. Common concerns include sudden cardiac arrest, advice on running injuries and how to avoid these events. Cardiologic screening and ergometry are only beneficial if the athlete has a high-risk profile. In the world of running, there are many myths regarding the prevention ofinjuries. Many recommendations on the use of running shoes, supportive insoles, running on soft or hard surfaces and the value of stretching have been made based on empirical evidence. The actual effects of these recommendations on injury prevention, however, have not been evaluated sufficiently. The value of preventive examination of structural and locomotor elements is also unclear at this time. Progression of training load in which the duration and intensity of training increases by less than 10% per week, appears to be the most reasonable way to prevent running injuries.