Sudden cardiac death risk factors in athletes at different sports training stages according to cardiac examination

Objective: to reveal the risk factors for sudden cardiac death (SCD) in athletes at different sports training stages according to a cardiac examination. Materials and methods: were examined 2245 athletes at 3 sports training stages according to in-depth medical examination program for each stage of sports training, established by the Order of the Ministry of Health No. 134n. Additionally, rhythmocardiography as well as 24-hour ECG monitoring were performed in cases of 2 or more extrasystoles detection on the resting ECG. The SCD risk factors were studied according to Russian National Recommendations: channelopathies, ventricular arrhythmias, hypersympathicotonia and reduction in heart rate variability, as well as left ventricular myocardial hypertrophy. Results: there was a significant increase in the identification of SCD risk factors from 4.3% to 11.7% from stage to stage of sports training. At the same time, the structure of SCD risk factors varied at different stages of sports training. Channelopathy occurred just at the first two stages. Ventricular extrasystoles were detected in 2.8% of sports mastery improvement stage athletes (SMIS) against 0.3% sport specialization stage (SSS) athletes. In SMIS athletes the second type of the cardiovascular system regulation by rhythmography was the most common finding. All the cases of heart geometry changes were related exclusively to highest sports mastery stage (HSMS), according to echocardiography, myocardial hypertrophy was not detected in other sports training stages athletes. The data obtained during statistical processing showed that the identified SCD risk have a significant relationship with the sports training stages. Conclusions: channelopathies were reliably associated with the SSS, ventricular premature beats and hypersympathicotonia were associated with SMIS, and myocardial hypertrophy with the HSMS. That should be taken into account when developing measures to prevent SCD in sports in terms of choosing medical control priority methods for the various stages of sports training process.

sports, athletes, sudden death, sudden cardiac death, stages of sports training, sudden death in sports

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