smjournalСпортивная медицина: наука и практикаSports medicine: research and practice2223-25242587-9014NEICON10.47529/2223-2524.2023.1.11smjournal-507Research ArticleВРАЧЕБНЫЙ КОНТРОЛЬMEDICAL CONTROLВозможности эхокардиографического скрининга у спортсменов. Часть 2. Структурные изменения сердцаPossibilities of echocardiographic screening in athletes. Part 2. Structural changes of the hearthttps://orcid.org/0000-0002-5378-7316ШарыкинА. С.SharykinA. S.

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

117997, Москва, ул. Островитянова, 1

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

1 Ostrovityanova str., Moscow, 117997

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 фармакологии; профессор кафедры восстановительной медицины, реабилитации и курортологии

105120, Москва, ул. Земляной Вал, 53

119296, Москва, Ленинский пр., д. 62/1

Viktoria A. Badtieva, corresponding member of the RAS, M.D., D.Sc. (Medicine), Professor, Head of Branch No. 1, Restorative and Sports Medicine of the Moscow Department of Healthcare, 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

62/1 Leninsky ave., Moscow, 119296

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) 

105120, Москва, ул. Земляной Вал, 53

Iuliia M. Ivanova, M.D., Ph.D. (Medicine), doctor of functional diagnostics, Department of  Functional Diagnostics and Sports Medicine, Branch No. 1, Restorative and Sports Medicine of the Moscow Department of Healthcare, Head of the Department of Sports Medicine and Clinical Pharmacology

53 Zemlyanoy Val str., Moscow, 105120

УсмановД. М.UsmanovD. M.

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

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

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 Federation202317072023131520Copyright © 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/507

Цель исследования: оценить пригодность существующих отечественных и международных рекомендаций и нормативов по использованию эхокардиографии (ЭхоКГ) в качестве скрининговой методики обследования спортсменов при различных заболеваниях.Материалы и методы: проведен метаанализ 59 отечественных и зарубежных источников литературы по результатам ЭхоКГ спортсменов. Изучены также 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 МНПЦ МРВСМ ДЗ г. Москвы.Результаты: скрининговая ЭхоКГ достоверно выявляет структурные отклонения в сердце спортсменов от популяционных норм, в т. ч. врожденные или приобретенные патологии, обусловливающие как внезапную смерть, так и общую заболеваемость.Заключение: с целью оперативного обследования спортсменов и снижения финансовых затрат уместно использовать первичное скрининговое, а при необходимости — углубленное обследование. При этом целесообразно выделение трех диагностических стадий, которые определяют опасность или допустимость занятий спортом: (А) — наличие риска развития осложнений, (В) — наличие структурных изменений сердца и (С) — появление клинических симптомов.

Objective

Objective: to assess the suitability of existing domestic and international recommendations and standards for the use of echocardiography as a screening technique for examining athletes with various diseases.

Materials and methods

Materials and methods: a meta‑analysis of 59 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

Results: screening echocardiography sufficiently reveals structural deviations of the heart of athletes from population norms, including congenital or acquired pathologies that cause both sudden death and general morbidity compared with a healthy population.

Conclusion

Conclusion: in order to speed up and reduce the cost of the examination of athletes, it is appropriate to use the primary screening, and if necessary, an in‑depth examination. In this case, it is advisable to distinguish three diagnostic stages that determine the danger or admissibility of playing sports: (A) — the risk of developing complications, (B) — the presence of structural changes in the heart, and (C) — the appearance of clinical symptoms.

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