Feasibility and Reliability of Nonexpert POCUS for Cardiovascular Preparticipation Screening of Varsity Athletes: The SHARP Protocol.

Autor: Moulson N; Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada., Jaff Z; Department of Medicine, Queen's University, Kingston, Ontario, Canada., Wiltshire V; Department of Athletics and Recreation, Queen's University, Kingston, Ontario, Canada., Taylor T; Department of Sports Medicine, University of Ottawa, Ottawa, Ontario, Canada., O'Connor HM; Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada., Hopman WM; Department of Medicine, Queen's University, Kingston, Ontario, Canada., Johri AM; Department of Medicine, Queen's University, Kingston, Ontario, Canada. Electronic address: amerschedule@gmail.com.
Jazyk: angličtina
Zdroj: The Canadian journal of cardiology [Can J Cardiol] 2019 Jan; Vol. 35 (1), pp. 35-41. Date of Electronic Publication: 2018 Nov 14.
DOI: 10.1016/j.cjca.2018.11.003
Abstrakt: Background: Point of care ultrasound (POCUS) is a potential adjunctive cardiovascular preparticipation screening modality for young competitive athletes. A novel cardiac POCUS screening protocol, Screening the Heart of the Athlete Research Program (SHARP), was developed for nonexpert examiners to assess common structural etiologies associated with sudden cardiac arrest/death (SCA/D).
Methods: Assessment of primary outcomes of feasibility, and reliability of obtained measurements, performed by comparison to formal transthoracic echocardiogram was undertaken. Inter-rater reliability was based on Intraclass correlation coefficients (ICC) defined as moderate for 0.40 to 0.59, good for 0.60 to 0.79, and excellent for 0.80 or greater. Electrocardiograms (ECGs) were also obtained. Identification of disease or other abnormalities was a secondary outcome.
Results: Fifty varsity athletes at our institution underwent the SHARP protocol, with 19 undergoing formal transthoracic echocardiogram and ECG for comparison. POCUS image quality was good to excellent. Feasibility of assessing for hypertrophic cardiomyopathy, aortic root dilatation, and left-ventricular function was deemed highly possible but limited in 20% for right-ventricular assessment. Reliability was good for measurements of interventricular septal thickness (0.67), end diastolic left-ventricular diameter (0.61), aortic root diameter (0.63), and moderate for left-ventricular posterior wall thickness (0.42). No cardiovascular abnormalities were detected.
Conclusions: A novel, comprehensive SHARP POCUS protocol performed by nonexpert practitioners demonstrated feasibility and reliability to assess varsity level athletes for common structural etiologies associated with SCA/D. Further large athlete screening cohort studies are required to validate the SHARP protocol and the role of cardiac POCUS as a screening modality.
(Copyright © 2018 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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