Heart Screenings Yield More False-Positives Among Black Athletes

TUESDAY, March 27 (HealthDay News) — The screenings European
athletes must undergo to detect possible heart conditions before they are
allowed to participate in sports should include race-specific criteria, a
new study suggests.

The current screening guidelines — which are used throughout Europe to
help doctors interpret the results of electrocardiograms (ECG) — are
based entirely on white athletes and could falsely identify many black
athletes as at risk for sudden cardiac death. These false-positive results
could lead to the wrongful disqualification of healthy black athletes, the
researchers cautioned. U.S. athletes are not required to undergo ECGs.

The European Society of Cardiology‘s screening guidelines for athletes
were revised in 2010 to reduce false positives. The study found, however,
that these revisions were more effective at reducing false positives among
whites than blacks.

“We need to develop ethnicity-specific guidelines when interpreting
ECGs for the purposes of pre-participation screens, specifically when it
comes to black athletes,” study author Nabeel Sheikh, cardiology registrar
and clinical research fellow at St. George’s Hospital in London and the
University of London, said in a news release.

The researchers, from St. George’s Hospital, the University of London
and the Institute of Health and Medical Research in Rennes, France,
examined heart screenings performed on 923 black athletes and 1,711 white
athletes, and 209 patients with hypertrophic cardiomyopathy, the leading
cause of sudden death in young athletes in the United States.

The study revealed that under the revised 2010 European guidelines, 43
percent of the participating black athletes, 13 percent of white athletes
and all of the hypertrophic cardiomyopathy patients would have been told
they needed further investigation.

Although that would have been an improvement from the original 2005
guidelines — which would have flagged 60 percent of black athletes and 49
percent of white athletes in the study — the research revealed additional
race-specific criteria would have reduced false positives even
further.

After the researchers developed new criteria, false positives were
further reduced, from 43 percent to 17 percent in black athletes and from
13 percent to 5 percent in white athletes.

The study, presented Sunday at the American College of Cardiology’s
annual meeting in Chicago, pointed out that heart screenings can be
difficult to interpret since athletic training often causes changes in the
heart that would be considered abnormal or worrisome in a person who was
not an athlete.

Research and data presented at medical meetings should be viewed as
preliminary until published in a peer-reviewed journal.

More information

The U.S. National Center for Sports Safety provides more information on
heart disease in athletes.

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