Noteworthy results in a 25-year systematic prescreening in Italy prompted international heart and sports medicine experts in Europe to call for a cardiovascular screening program. Italy's mandatory eligibility test relies heavily on the 12-lead ECG and involves nearly 6 million young people each year. An ECG is an electrical recording of the heart that is used in the investigation of heart disease.

In one 17-year study involving 34,000 athletes under age 35, more than 1,000 were disqualified from competing on health grounds; 621 were disqualified because the tests revealed relevant cardiovascular abnormalities.

Prescreening in the United States includes physical examinations and medical history, but the 12-lead ECG is only performed at the doctor's discretion. The American Heart Association previously assumed that ECG would not be cost-effective for screening because of low specificity. "In fact, this is not the case," says Domenico Corrado, M.D., Ph.D., from the departments of cardiology and pathology at the University of Padova, Italy. "...ECG is abnormal in up to 95 percent of patients with hypertropic cardiomyopathy (HCM), which is the leading cause of sudden death in an athlete."

Compared to the findings in Italy where ECG is used, research in the United States shows a similar prevalence of HCM in non-sport, sudden cardiac death. However, researchers found a significant difference -- 2 percent vs. 24 percent -- in sports-related cardiovascular events.

Based on the prescreening system in Italy, which has significantly reduced young athlete's sports-related sudden death from HCM, the authors suggest ECG screening has the potential to reduce sports-related cardiac deaths in Europe by between 50 percent and 70 percent if it can be implemented in every country. Dr. Corrado concludes, "From all the evidence that we have from 25 years experience in Italy, we can state unequivocally that screening is warranted."

SOURCE: European Heart Journal, Feb. 2, 2005