Clinical significance of ST depression at exercise stress testing in competitive athletes: usefulness of coronary CT during screening
| Autor: | Federico Quaranta, Attilio Parisi, Federica Fagnani, Mauro Di Roma, Antonia Nigro, Chiara Lanzillo, Carlo Minganti, Luciano Maresca, Fabio Sperandii, Emanuele Guerra, Leonardo Calò, Eliana Tranchita |
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| Rok vydání: | 2017 |
| Předmět: |
Myocardial bridge
Adult Male medicine.medical_specialty Sports medicine Population Physical Therapy Sports Therapy and Rehabilitation Coronary Artery Disease 030204 cardiovascular system & hematology Coronary Angiography Sudden cardiac death Coronary artery disease 03 medical and health sciences Coronary artery bypass surgery 0302 clinical medicine Internal medicine medicine Humans Orthopedics and Sports Medicine cardiovascular diseases 030212 general & internal medicine Coronary Artery Bypass education ST depression education.field_of_study biology business.industry Athletes Middle Aged medicine.disease biology.organism_classification Death Sudden Cardiac Cardiology Exercise Test Female medicine.symptom business Tomography X-Ray Computed |
| Zdroj: | The Journal of sports medicine and physical fitness. 58(12) |
| ISSN: | 1827-1928 |
| Popis: | Background Congenital coronary anomalies (CCAs) and coronary artery disease (CAD) arouse intense scientific and clinical interest in sports medicine and sports cardiology medical communities because of their potential to trigger sudden cardiac death (SCD) in athletes. Exercise stress testing represent the first instrumental assessment to evaluate electrocardiographic changes during effort. Coronary computed tomography angiography (CCTA) is an advanced accurate noninvasive imaging modality for excluding CAD and abnormalities of origin and course of coronary vessels. The aim of this study is to investigate with CCTA the clinical significance of ST depression suggestive for myocardial ischemia during exercise stress testing in athletes and to determine the prevalence of CAD and/or CCAs. Methods Sixty-five consecutive athletes showing electrocardiographic findings positive or equivocal for myocardial ischemia on exercise stress testing during pre-participation screening were investigated with CCTA. Results Among the 65 athletes investigated, 36 showed Myocardial Bridge (MB), one showed an anomalous coronary origin and seven showed CAD. Among 36 athletes with MB, 4 were associated with mild coronary artery stenosis. Three athletes with CAD needed percutaneous transluminal coronary angioplasty or coronary artery bypass surgery. Conclusions In competitive athletes even with excellent workload capacities, in absence of cardiomyopathy, the presence of ischemic electrocardiographic abnormalities could be mainly determined by a coronary congenital or acquired pathology. In this population CCTA is a useful imaging modality of choice for the risk stratification and for the diagnostic process, to allow eligible athletes to compete and to follow-up subjects requiring medical surveillance. |
| Databáze: | OpenAIRE |
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