smjournalСпортивная медицина: наука и практикаSports medicine: research and practice2223-25242587-9014NEICON10.47529/2223-2524.2022.3.8smjournal-444Research ArticleФУНКЦИОНАЛЬНАЯ ДИАГНОСТИКАFUNCTIONAL TESTINGВозможности эхокардиографического скрининга у спортсменов. Часть 1. Нормативные показателиPossibilities of echocardiographic screening in athletes. Part 1. Normal valueshttps://orcid.org/0000-0002-5378-7316ШарыкинА. С.SharykinA. S.

Шарыкин Александр Сергеевич,  д.м.н., профессор кафедры госпитальной педиатрии им. академика В.А. Таболина

Россия, 117997, Москва, ул. Островитянова, 1

Alexander S. Sharykin, D.Sc. (Medicine), Professor of the Department of Hospital Pediatrics

1, Ostrovityanova str., Moscow, 117997, Russia 

https://orcid.org/0000-0003-4291-679XБадтиеваВ. А.BadtievaV. A.

Бадтиева Виктория Асланбековна, член‑корр. РАН, д.м.н., профессор, заведующая филиалом № 1; руководитель отдела спортивной медицины и клинической фармакологи; профессор кафедры восстановительной медицины, реабилитации и курортологии 

Россия, 105120, Москва, ул. Земляной Вал, 53

Россия, 119296, Москва, Ленинский проспект, д. 62/1

Viktoria A. Badtieva, corresponding member of the RAS, M.D., D.Sc. (Medicine), Professor, Head of Branch No. 1; Head of the Department of Sports Medicine and Clinical Pharmacology; Professor of the Department of Restorative Medicine, Rehabilitation and Balneology

53, Zemlyanoy Val str., Moscow, 105120, Russia;

62/1, Leninsky prospect, Moscow, 119296, Russia 

https://orcid.org/0000-0002-4616-8322ИвановаЮ. М.IvanovaIu. M.

Иванова Юлия Михайловна, к.м.н., врач функциональной диагностики, отделения  функциональной диагностики и спортивной медицины Клиники спортивной медицины (филиал №1) 

Россия, 105120, Москва, ул. Земляной Вал, 53

Iuliia M. Ivanova, MD, Ph.D., doctor of functional diagnostics, Department of Functional Diagnostics and Sports Medicine, Branch No. 1; Head of theDepartment of Sports Medicine and Clinical Pharmacology

53, Zemlyanoy Val str., Moscow, 105120, Russia 

УсмановД. М.UsmanovD. M.

Усманов Дамир Мунирович, врач спортивной медицины, отдела медицинского обеспечения спортивных сборных команд и соревнований

Россия, 121059, Москва, Большая Дорогомиловская ул., 5 

Dmitriy M. Usmanov, doctor of sports medicine, Department of medical support for sports teams and competitions

5, Bolshaya Dorogomilivskaya str., Moscow, 121059, Russia 

ГАУЗ «Московский научно-практический центр медицинской реабилитации, восстановительной и спортивной медицины Департамента здравоохранения г. Москвы»; ФГБУ «Федеральный научно-клинический центр спортивной медицины и реабилитации Федерального медико-биологического агентства»; ФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава РоссииРоссияMoscow Scientific and Practical Center for Medical Rehabilitation and Sports Medicine; Federal Research and Clinical Center of Sports Medicine and Rehabilitation of Federal Medical Biological Agency; Pirogov Russian National Research Medical UniversityRussian FederationГАУЗ «Московский научно-практический центр медицинской реабилитации, восстановительной и спортивной медицины Департамента здравоохранения г. Москвы»; ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский университет)РоссияMoscow Scientific and Practical Center for Medical Rehabilitation and Sports Medicine; Sechenov First Moscow State Medical UniversityRussian FederationГАУЗ «Московский научно-практический центр медицинской реабилитации, восстановительной и спортивной медицины Департамента здравоохранения г. Москвы»РоссияMoscow Scientific and Practical Center for Medical Rehabilitation and Sports MedicineRussian FederationФГБУ «Федеральный научно-клинический центр спортивной медицины и реабилитации Федерального медико-биологического агентства»РоссияFederal Research and Clinical Center of Sports Medicine and Rehabilitation of Federal Medical Biological AgencyRussian Federation2022151120221237283Copyright © Шарыкин А.С., Бадтиева В.А., Иванова Ю.М., Усманов Д.М., 20232023Шарыкин А.С., Бадтиева В.А., Иванова Ю.М., Усманов Д.М.Sharykin A.S., Badtieva V.A., Ivanova I.M., Usmanov D.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.smjournal.ru/jour/article/view/444

Цель исследования: оценить пригодность существующих отечественных и международных рекомендаций по использованию ЭхоКГ в качестве скрининговой методики обследования спортсменов; выбрать нормативы, характеризующие сердце в разных видах спорта на основании собственных исследований.Материалы и методы: проведен метаанализ 38 отечественных и зарубежных источников литературы по результатам эхокардиографического обследования спортсменов. Изучены показатели 2647 спортсменов‑мужчин в возрасте от 16 до 45 лет, выступающих за сборные команды Москвы и прошедших углубленное медицинское обследование на базе Клиники спортивной медицины МНПЦМРВиСМ ДЗ г. Москвы.Результаты: размеры сердца у спортсменов незначительно отличаются от популяционных показателей, однако в 14–45% случаев выходят за референсные значения. В отсутствие заболеваний сердца наибольшие размеры левого желудочка (ЛЖ) отмечаются у лиц, тренирующих выносливость. При этом высокие функциональные возможности коррелируют с увеличенным объемом ЛЖ, индексированным по ППТ (для КДО/ППТ и VO2 ПАНО r = 0,52, p < 0,05).Заключение: эхокардиографический скрининг спортсменов позволяет получить достаточную информацию для выявления врожденной или возникшей в процессе чрезмерных тренировочных нагрузок патологии. В качестве нормативов целесообразно использовать популяционные показатели, выраженные в центильных величинах.

Objective: assess the suitability of existing domestic and international recommendations for the use of echocardiography as a screening method for examining athletes; to select standards that characterize the heart in different sports, based on their own research.Materials and methods: a meta‑analysis of 38 domestic and foreign literature sources based on the results of an echocardiographic examination of athletes was carried out. The indicators of 2647 male athletes aged 16 to 45 years old, playing for the national teams of the city of Moscow and having passed an in‑depth medical examination at the Sports Medicine Clinic, were studied.Results: heart sizes in athletes differ slightly from population indicators, however, in 14–45% of cases they go beyond the reference values. In the absence of heart disease, the largest dimensions of the left ventricle (LV) are observed in endurance exercisers. At the same time, high functionality correlates with increased LV volume indexed by BCA (for EDV/BSA and VO2 AT r = 0.52, p < 0.05).Conclusion: echocardiographic screening of athletes allows obtaining sufficient information to identify congenital or pathology that has arisen during excessive training loads. As standards, it is advisable to use population indicators expressed in centile values.

спортсменывнезапная сердечная смертьгипертрофиявнезапная остановка сердцаэхокардиографияathletessudden cardiac deathhypertrophysudden cardiac arrestechocardiographyReferencesРевишвили А.Ш., Неминущий Н.М., Баталов Р.Е., Гиляров М.Ю., Голицын С.П., Давтян К.В., Думпис Я.Ю. и др. Всероссийские клинические рекомендации по контролю над риском внезапной остановки сердца и внезапной сердечной смерти, профилактике и оказанию первой помощи. Вестник аритмологии. 2017;(89):1–104.Revishvili A.Sh., Neminushchii N.M., Batalov R.E., Gilyarov M.Yu., Golitsyn S.P., Davtyan K.V. All Russian Clinical Guidelines for Controlling the Risk of Sudden Cardiac Arrest and Sudden Cardiac Death, Prevention and First Aid. Vestnik aritmologii = Journal of Arrhythmology. 2017;(89):2–104 (In Russ.).Stiles M.K., Wilde A.A.M., Abrams D.J., Ackerman M.J. et al. 2020 APHRS/HRS expert consensus statement on the investigation of decedents with sudden unexplained death and patients with sudden cardiac arrest, and of their families. J. Arrhythm. 2021;37(3):481–534. https://doi.org/10.1002/joa3.12449.Stiles M.K., Wilde A.A.M., Abrams D.J., Ackerman M.J. et al. 2020 APHRS/HRS expert consensus statement on the investigation of decedents with sudden unexplained death and patients with sudden cardiac arrest, and of their families. J. Arrhythm. 2021;37(3):481–534. https://doi.org/10.1002/joa3.12449.Drezner J.A., O'Connor F.G., Harmon K.G., et al. AMSSM Position Statement on Cardiovascular Preparticipation Screening in Athletes: Current evidence, knowledge gaps, recommendations and future directions [published correction appears in Br J Sports Med. 2018 Mar 6;:]. Br. J. Sports Med. 2017;51(3):153–167. https://doi.org/10.1136/bjsports–2016–096781Drezner J.A., O'Connor F.G., Harmon K.G., et al. AMSSM Position Statement on Cardiovascular Preparticipation Screening in Athletes: Current evidence, knowledge gaps, recommendations and future directions [published correction appears in Br J Sports Med. 2018 Mar 6;:]. Br. J. Sports Med. 2017;51(3):153–167. https://doi.org/10.1136/bjsports–2016–096781Vetter V.L., Dugan N., Guo R., Mercer-Rosa L., Gleason M., Cohen M., Vogel R.L., Iyer R. A pilot study of the feasibility of heart screening for sudden cardiac arrest in healthy children. Am. Heart J. 2011;161(5):1000–1006.e3. https://doi.org/10.1016/j.ahj.2011.01.022Vetter V.L., Dugan N., Guo R., Mercer-Rosa L., Gleason M., Cohen M., Vogel R.L., Iyer R. A pilot study of the feasibility of heart screening for sudden cardiac arrest in healthy children. Am. Heart J. 2011;161(5):1000–1006.e3. https://doi.org/10.1016/j.ahj.2011.01.022Corrado D., Pelliccia A., Bjørnstad H.H., Vanhees L., Biffi A., Borjessonet M., et al. Cardiovascular pre–participation screening of young competitive athletes for prevention of sudden death: proposal for a common European protocol. Consensus Statement of the Study Group of Sport Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology. Eur. Heart J. 2005;26(5):516–524. https://doi.org/10.1093/eurheartj/ehi108Corrado D., Pelliccia A., Bjørnstad H.H., Vanhees L., Biffi A., Borjessonet M., et al. Cardiovascular pre–participation screening of young competitive athletes for prevention of sudden death: proposal for a common European protocol. Consensus Statement of the Study Group of Sport Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology. Eur. Heart J. 2005;26(5):516–524. https://doi.org/10.1093/eurheartj/ehi108Çetin İ.I., Ekici F., Kibar A.E., Sürücü M., Orgun A. The pre participation screening in young athletes: which protocol do we need exactly? Cardiol. Young. 2018;28(4):536–541. https://doi.org/10.1017/S1047951117002438Çetin İ.I., Ekici F., Kibar A.E., Sürücü M., Orgun A. The pre participation screening in young athletes: which protocol do we need exactly? Cardiol. Young. 2018;28(4):536–541. https://doi.org/10.1017/S1047951117002438Toresdahl B.G., Asif I.M., Rodeo S.A., Ling D.I., Chang C.J. Cardiovascular screening of Olympic athletes reported by chief medical officers of the Rio 2016 Olympic Games. Br. J. Sports Med. 2018;52(17):1097–1100. https://doi.org/10.1136/bjsports–2018–099029Toresdahl B.G., Asif I.M., Rodeo S.A., Ling D.I., Chang C.J. Cardiovascular screening of Olympic athletes reported by chief medical officers of the Rio 2016 Olympic Games. Br. J. Sports Med. 2018;52(17):1097–1100. https://doi.org/10.1136/bjs ports–2018–099029Risgaard B., Tfelt-Hansen J., Winkel B.G. Sports–related sudden cardiac death: How to prove an effect of preparticipation screening? Heart Rhythm. 2016;13(7):1560–1562. https://doi.org/10.1016/j.hrthm.2016.03.043Risgaard B., Tfelt-Hansen J., Winkel B.G. Sports–related sudden cardiac death: How to prove an effect of preparticipation screening? Heart Rhythm. 2016;13(7):1560–1562. https://doi.org/10.1016/j.hrthm.2016.03.043Petek B.J., Baggish A.L. Current controversies in pre–participation cardiovascular screening for young competitive athletes. Expert Rev. Cardiovasc. Ther. 2020;18(7):435–442. https://doi.org/10.1080/14779072.2020.1787154Petek B.J., Baggish A.L. Current controversies in pre–participation cardiovascular screening for young competitive athletes. Expert Rev. Cardiovasc. Ther. 2020;18(7):435–442. https://doi.org/10.1080/14779072.2020.1787154Alpert J.S. Does Resting or Exercise Electrocardiography Assist Clinicians in Preventing Cardiovascular Events in Asymptomatic Adults? JAMA Cardiol. 2018;3(8):678–679. https://doi.org/10.1001/jamacardio.2018.1800Alpert J.S. Does Resting or Exercise Electrocardiography Assist Clinicians in Preventing Cardiovascular Events in Asymptomatic Adults? JAMA Cardiol. 2018;3(8):678–679. https://doi.org/10.1001/jamacardio.2018.1800Steinvil A., Chundadze T., Zeltser D., Rogowski O., Halkin A., Galily Y., Perluk H., Viskin S. Mandatory electro cardiographic screening of athletes to reduce their risk for sudden death proven fact or wishful thinking? J. Am. Coll. Cardiol. 2011;57(11):1291–1296. https://doi.org/10.1016/j.jacc.2010.10.037Steinvil A., Chundadze T., Zeltser D., Rogowski O., Halkin A., Galily Y., Perluk H., Viskin S. Mandatory electro cardiographic screening of athletes to reduce their risk for sudden death proven fact or wishful thinking? J. Am. Coll. Cardiol. 2011;57(11):1291–1296. https://doi.org/10.1016/j.jacc.2010.10.037Orchard J.J., Orchard J.W., La Gerche A., Semsarian C. Cardiac screening of athletes: consensus needed for clinicians on indications for follow–up echocardiography testing. Br J. Sports. Med. 2020;54(15):936–938. https://doi.org/10.1136/bjsports-2019-101916Orchard J.J., Orchard J.W., La Gerche A., Semsarian C. Cardiac screening of athletes: consensus needed for clinicians on indications for follow–up echocardiography testing. Br J. Sports. Med. 2020;54(15):936–938. https://doi.org/10.1136/bjs ports 2019 101916Sharma S., Drezner J.A., Baggish A., Papadakis M., Wilson M.G., Prutkin J.M., et al. International recommendations for electrocardiographic interpretation in athletes. Eur. Heart J. 2018;39(16):1466–1480. https://doi.org/10.1093/eurheartj/ehw631Sharma S., Drezner J.A., Baggish A., Papadakis M., Wilson M.G., Prutkin J.M., et al. International recommendations for electrocardiographic interpretation in athletes. Eur. Heart J. 2018;39(16):1466–1480. https://doi.org/10.1093/eurheartj/ehw631Lang R.M., Bierig M., Devereux R.B., Flachskampf F.A., Foster E., Pellikkaet P.A., et al. Recommendations for chamber quantification. Eur. J. Echocardiogr. 2006;7(2):79–108. https://doi.org/10.1016/j.euje.2005.12.014Lang R.M., Bierig M., Devereux R.B., Flachskampf F.A., Foster E., Pellikkaet P.A., et al. Recommendations for chamber quantification. Eur. J. Echocardiogr. 2006;7(2):79–108. https://doi.org/10.1016/j.euje.2005.12.014Lang R.M., Badano L.P., Mor-Avi V., Afilalo J., Armstrong A., Ernande L., et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur. Heart J. Cardiovasc. Imag. 2015;16(3):233–270. https://doi.org/10.1093/ehjci/jev014Lang R.M., Badano L.P., Mor-Avi V., Afilalo J., Armstrong A., Ernande L., et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur. Heart J. Cardiovasc. Imag. 2015;16(3):233–270. https://doi.org/10.1093/ehjci/jev014Hiratzka L.F., Bakris G.L., Beckman J.A., Bersin R.M., Carr V.F., Casey D.E. Jr, et al. ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the diagnosis and management of patients with thoracic aortic disease. A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine. J. Am. Coll. Cardiol. 2010;55(14):e27–e129. https://doi.org/10.1016/j.jacc.2010.02.015. Erratum in: J. Am. Coll. Cardiol. 2013;62(11):1039–1040.Hiratzka L.F., Bakris G.L., Beckman J.A., Bersin R.M., Carr V.F., Casey D.E. Jr, et al. ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the diagnosis and management of patients with thoracic aortic disease. A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine. J. Am. Coll. Cardiol. 2010;55(14):e27–e129. https://doi.org/10.1016/j.jacc.2010.02.015. Erratum in: J. Am. Coll. Cardiol. 2013;62(11):1039–1040.Fernandes L.P., Barreto A.T.F., Neto M.G., Câmara E.J.N., Durães A.R., Roever L., Aras-Júnior R. Prognostic power of conventional echocardiography in individuals without history of cardiovascular diseases: A systematic review and meta–analysis. Clinics (Sao Paulo). 2021;76:e2754. https://doi.org/10.6061/clinics/2021/e2754Fernandes L.P., Barreto A.T.F., Neto M.G., Câmara E.J.N., Durães A.R., Roever L., Aras-Júnior R. Prognostic power of conventional echocardiography in individuals without history of cardiovascular diseases: A systematic review and meta–analysis. Clinics (Sao Paulo). 2021;76:e2754. https://doi.org/10.6061/clinics/2021/e2754Riding N.R., Othman Salah O., Sharma S., Carré F., O'Hanlon R., George K.P., et al. Do big athletes have big hearts? Impact of extremeanthropometry upon cardiac hypertrophy inprofessional male athletes. Br. J. Sports Med 2012;46 (SupplI):i90–i97. https://doi.org/10.1136/bjsports-2012-091258Riding N.R., Othman Salah O., Sharma S., Carré F., O'Hanlon R., George K.P., et al. Do big athletes have big hearts? Impact of extremeanthropometry upon cardiac hypertrophy inprofessional male athletes. Br. J. Sports Med 2012;46 (SupplI):i90–i97. https://doi.org/10.1136/bjsports 2012 091258Gati S., Malhotra A., Sedgwick C., Papamichael N., Dhutia H., Sharma R., et al. Prevalence and progression of aortic root dilatation in highly trained young athletes. Heart. 2019;105(12):920–925. https://doi.org/10.1136/heartjnl-2018–314288Gati S., Malhotra A., Sedgwick C., Papamichael N., Dhutia H., Sharma R., et al. Prevalence and progression of aortic root dilatation in highly trained young athletes. Heart. 2019;105(12):920–925. https://doi.org/10.1136/heartjnl 2018–314288Siddiqi H., Isselbacher E., Suzuki T., Montgomery D., Pape L., Fattori R., et al. Is size a good predictor of dissection risk in patients with Marfan syndrome or bicuspid aortic valves? Insights from the international registry of acute aortic dissection (IRAD). J. Am. Coll. Cardiol. 2012;59(13_Supplement):E1883. https://doi.org/10.1016/s0735-1097(12)61884-1Siddiqi H., Isselbacher E., Suzuki T., Montgomery D., Pape L., Fattori R., et al. Is size a good predictor of dissection risk in patients with Marfan syndrome or bicuspid aortic valves? Insights from the international registry of acute aortic dissection (IRAD). J. Am. Coll. Cardiol. 2012;59(13_Supplement):E1883. https://doi.org/10.1016/s0735 1097(12)61884 1Pelliccia A., Sharma S., Gati S., Bäck M., Börjesson M., Caselli S., et al.; ESC Scientific Document Group. 2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease. Eur. Heart J. 2021;42(1):17–96. https://doi.org/10.1093/eurheartj/ehaa605. Erratum in: Eur. Heart. J. 2021;42(5):548–549.Pelliccia A., Sharma S., Gati S., Bäck M., Börjesson M., Caselli S., et al.; ESC Scientific Document Group. 2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease. Eur. Heart J. 2021;42(1):17–96. https://doi.org/10.1093/eurheartj/ehaa605. Erratum in: Eur. Heart. J. 2021;42(5):548–549.Hiratzka L.F., Bakris G.L., Beckman J.A., Bersin R.M., Carr V.F., Casey D.E. Jr, et al. 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with Thoracic Aortic Disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine. Circulation. 2010;121(13):e266–369. https://doi.org/10.1161/CIR.0b013e3181d4739eHiratzka L.F., Bakris G.L., Beckman J.A., Bersin R.M., Carr V.F., Casey D.E. Jr, et al. 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with Thoracic Aortic Disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine. Circulation. 2010;121(13):e266–369. https://doi.org/10.1161/CIR.0b013e3181d4739ePelliccia A., Caselli S., Sharma S., Basso C., Bax J.J., Corrado D., et al. Internal reviewers for EAPC and EACVI. European Association of Preventive Cardiology (EAPC) and European Association of Cardiovascular Imaging (EACVI) joint position statement: recommendations for the indication and interpretation of cardiovascular imaging in the evaluation of the athlete's heart. Eur. Heart J. 2018;39(21):1949–1969. https://doi.org/10.1093/eurheartj/ehx532Pelliccia A., Caselli S., Sharma S., Basso C., Bax J.J., Corrado D., et al. Internal reviewers for EAPC and EACVI. European Association of Preventive Cardiology (EAPC) and European Association of Cardiovascular Imaging (EACVI) joint position statement: recommendations for the indication and interpretation of cardiovascular imaging in the evaluation of the athlete's heart. Eur. Heart J. 2018;39(21):1949–1969. https://doi.org/10.1093/eurheartj/ehx532Weiner R.B., Wang F., Hutter A.M. Jr., Wood M.J., Berkstresser B., McClanahan C., et al. The feasibility, diagnostic yield, and learning curve of portable echocardiography for out–of–hospital cardiovascular disease screening. J. Am. Soc. Echocardiogr. 2012;25(5):568–575. https://doi.org/10.1016/j.echo.2012.01.010Weiner R.B., Wang F., Hutter A.M. Jr., Wood M.J., Berkstresser B., McClanahan C., et al. The feasibility, diagnostic yield, and learning curve of portable echocardiography for out–of–hospital cardiovascular disease screening. J. Am. Soc. Echocardiogr. 2012;25(5):568–575. https://doi.org/10.1016/j.echo.2012.01.010Pluim B.M., Zwinderman A.H., van der Laarse A., van-der Wall E.E. The athlete's heart. A meta analysis of cardiacstructure and function. Circulation. 2000;101(3):336–344. https://doi.org/10.1161/01.cir.101.3.336Pluim B.M., Zwinderman A.H., van der Laarse A., van-der Wall E.E. The athlete's heart. A meta analysis of cardiacstructure and function. Circulation. 2000;101(3):336–344. https://doi.org/10.1161/01.cir.101.3.336Utomi V., Oxborough D., Whyte G.P., Somauroo J., Sharma S., Shave R., Atkinson G., George K. Systematic review and meta–analysis of training mode, imaging modality and body size influences on the morphology and function of the male athlete’s heart. Heart. 2013;99(23):1727–1733. https://doi.org/10.1136/heartjnl-2012-303465Utomi V., Oxborough D., Whyte G.P., Somauroo J., Sharma S., Shave R., Atkinson G., George K. Systematic review and meta–analysis of training mode, imaging modality and body size influences on the morphology and function of the male athlete’s heart. Heart. 2013;99(23):1727–1733. https://doi.org/10.1136/heartjnl 2012 303465Caselli S., Di Paolo F.M., Pisicchio C., Pandian N.G., Pelliccia A. Patterns of Left Ventricular Diastolic Function in Olympic Athletes. J. Am. Soc. Echocardiogr. 2015;28(2):236–244. https://doi.org/10.1016/j.echo.2014.09.013Caselli S., Di Paolo F.M., Pisicchio C., Pandian N.G., Pelliccia A. Patterns of Left Ventricular Diastolic Function in Olympic Athletes. J. Am. Soc. Echocardiogr. 2015;28(2):236–244. https://doi.org/10.1016/j.echo.2014.09.013Albaeni A., Davis J.W., Ahmad M. Echocardiographic evaluation of the Athlete's heart. Echocardiography. 2021;38(6):1002–1016. https://doi.org/10.1111/echo.15066Albaeni A., Davis J.W., Ahmad M. Echocardiographic evaluation of the Athlete's heart. Echocardiography. 2021;38(6):1002–1016. https://doi.org/10.1111/echo.15066Шарыкин А.С., Иванова Ю.М., Павлов В.И., Бадтиева В.А., Субботин П.А. Варианты ремоделирования сердца у детей и подростков в игровых видах спорта (на примере футбола и хоккея). Педиатрия. 2016;95(3):65–72.Sharyikin A.S., Ivanova Yu.M., Pavlov V.I., Badtieva V.A., Subbotin P.A. Cardiac remodeling variants in children and adolescents in team sports (on the example of football and hockey). Pediatria n.a. G.N. Speransky. 2016;95(3):65–72 (In Russ.).Leslie L.K., Cohen J.T., Newburger J.W., Alexander M.E., Wong J.B., Sherwin E.D., et al. Costs and benefits of targeted screening for causes of sudden cardiac death in children and adolescents. Circulation. 2012;125(21):2621–2629. https://doi.org/10.1161/CIRCULATIONAHA.111.087940Leslie L.K., Cohen J.T., Newburger J.W., Alexander M.E., Wong J.B., Sherwin E.D., et al. Costs and benefits of targeted screening for causes of sudden cardiac death in children and adolescents. Circulation. 2012;125(21):2621–2629. https://doi.org/10.1161/CIRCULATIONAHA.111.087940Weiner R.B., Wang F., Hutter A.M. Jr., Wood M.J., Berkstresser B., McClanahan C., et al. The feasibility, diagnostic yield, and learning curve of portable echocardiography for out–of–hospital cardiovascular disease screening. J. Am. Soc. Echocardiogr. 2012;25(5):568–575. https://doi.org/10.1016/j.echo.2012.01.010Weiner R.B., Wang F., Hutter A.M. Jr., Wood M.J., Berkstresser B., McClanahan C., et al. The feasibility, diagnostic yield, and learning curve of portable echocardiography for out–of–hospital cardiovascular disease screening. J. Am. Soc. Echocardiogr. 2012;25(5):568–575. https://doi.org/10.1016/j.echo.2012.01.010Narula S., Shameer K., Salem Omar A.M., Dudley J.T., Sengupta P.P. Machine–Learning Algorithms to Automate Morphological and Functional Assessments in 2D Echocardiography. J. Am. Coll. Cardiol. 2016;68(21):2287–2295. https://doi.org/10.1016/j.jacc.2016.08.062Narula S., Shameer K., Salem Omar A.M., Dudley J.T., Sengupta P.P. Machine–Learning Algorithms to Automate Morphological and Functional Assessments in 2D Echocardiography. J. Am. Coll. Cardiol. 2016;68(21):2287–2295. https://doi.org/10.1016/j.jacc.2016.08.062Moulson N., Jaff Z., Wiltshire V., Taylor T., O'Connor H.M., Hopman W.M., Johri A.M. Feasibility and Reliability of Nonexpert POCUSfor Cardiovascular Preparticipation Screening of Varsity Athletes: The SHARP Protocol. Can. J. Cardiol. 2019;35(1):35–41. https://doi.org/10.1016/j.cjca.2018.11.003Moulson N., Jaff Z., Wiltshire V., Taylor T., O'Connor H.M., Hopman W.M., Johri A.M. Feasibility and Reliability of Nonexpert POCUSfor Cardiovascular Preparticipation Screening of Varsity Athletes: The SHARP Protocol. Can. J. Cardiol. 2019;35(1):35–41. https://doi.org/10.1016/j.cjca.2018.11.003Liu H.W.,Huang L.W.,Chiu S.N.,Lue H.C.,Wu M.H.,Chen M.R., Wang J.K. Cardiac Screening for High Risk Sudden Cardiac Death in School Aged Children. Acta Cardiol. Sin. 2020;36(6):641–648. https://doi.org/10.6515/ACS.202011_36(6).20200515ALiu H.W.,Huang L.W.,Chiu S.N.,Lue H.C.,Wu M.H.,Chen M.R., Wang J.K. Cardiac Screening for High Risk Sudden Cardiac Death in School Aged Children. Acta Cardiol. Sin. 2020;36(6):641–648. https://doi.org/10.6515/ACS.202011_36(6).20200515AШарыкин А.С., Бадтиева В.А., Трунина И.И., Османов И.М. Фиброз миокарда — новый компонент ремоделирования сердца у спортсменов? Кардиоваскулярная терапия и профилактика. 2019;18(6):126–135. https://doi.org/10.15829/1728-8800-2019-6-126-135Sharykin A.S., Badtieva V.A., Trunina I.I., Osmanov I.M. Myocardial fibrosis — a new component of heart remodeling in athletes? Cardiovascular Therapy and Prevention. 2019;18(6):126–135. (In Russ.). https://doi.org/10.15829/1728 8800 2019 6 126 135Jortveit J., Klcovansky J., Døhlen G., Eskedal L., Birkeland S., Holmstrøm H. Out of hospital sudden cardiac arrest in children with congenital heart defects. Arch. Dis. Child. 2018;103(1):57–60. https://doi.org/10.1136/archdischild-2017-312621Jortveit J., Klcovansky J., Døhlen G., Eskedal L., Birkeland S., Holmstrøm H. Out of hospital sudden cardiac arrest in children with congenital heart defects. Arch. Dis. Child. 2018;103(1):57–60. https://doi.org/10.1136/archdischild 2017 312621Weiner R.B., Wang F., Hutter A.M. Jr., Wood M.J., Berkstresser B., McClanahan C., et al. The feasibility, diagnostic yield, and learning curve of portable echocardiography for out–of–hospital cardiovascular disease screening. J. Am. Soc. Echocardiogr. 2012;25(5):568–575. https://doi.org/10.1016/j.echo.2012.01.010Weiner R.B., Wang F., Hutter A.M. Jr., Wood M.J., Berkstresser B., McClanahan C., et al. The feasibility, diagnostic yield, and learning curve of portable echocardiography for out–of–hospital cardiovascular disease screening. J. Am. Soc. Echocardiogr. 2012;25(5):568–575. https://doi.org/10.1016/j.echo.2012.01.010Baggish A.L., Wood M.J. Athlete's heart and cardiovascular care of the athlete: scientific and clinical update. Circulation. 2011;123(23):2723–2735. https://doi.org/10.1161/CIRCULATIONAHA.110.981571Baggish A.L., Wood M.J. Athlete's heart and cardiovascular care of the athlete: scientific and clinical update. Circulation. 2011;123(23):2723–2735. https://doi.org/10.1161/CIRCULATIONAHA.110.981571Galderisi M., Cardim N., D'Andrea A., Bruder O., Cosyns B., Davin L., et al. The multi–modality cardiac imaging approach to the Athlete's heart: an expert consensus of the European Association of Cardiovascular Imaging. Eur. Heart. J. Cardiovasc. Imaging. 2015;16(4):353. https://doi.org/10.1093/ehjci/jeu323Galderisi M., Cardim N., D'Andrea A., Bruder O., Cosyns B., Davin L., et al. The multi–modality cardiac imaging approach to the Athlete's heart: an expert consensus of the European Association of Cardiovascular Imaging. Eur. Heart. J. Cardiovasc. Imaging. 2015;16(4):353. https://doi.org/10.1093/ehjci/jeu323

The authors declare that there are no conflicts of interest present.