Significance of extended sports cardiology screening of elite handball referees

• Published in: PloS one Vol. 16; no. 4; p. e0249923
• Main Authors: Kiss, Orsolya, Babity, Mate, Kovacs, Attila, Skopal, Judit, Vago, Hajnalka, Lakatos, Balint Karoly, Bognar, Csaba, Rakoczi, Reka, Zamodics, Mark, Frivaldszky, Lorinc, Menyhart-Hetenyi, Anna, Dohy, Zsofia, Czimbalmos, Csilla, Szabo, Liliana, Merkely, Bela
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 09.04.2021; Public Library of Science (PLoS)
• Subjects: Asymptomatic; Athletes; Authoring; Authorship; Biology and Life Sciences; Blood cells; Blood pressure; Cardiology; Cardiovascular diseases; Computed tomography; Demographic aspects; Editing; EKG; Electrocardiogram; Electrocardiography; Exercise; Families & family life; Family medical history; Genetics; Handball; Health aspects; Heart; Hemoglobin; Kinases; L-Lactate dehydrogenase; Laboratories; Lactate dehydrogenase; Lactic acid; Lipids; Magnetic resonance; Magnetic resonance imaging; Medicine and Health Sciences; Myocardial infarction; Overweight; Physical fitness; Physiological aspects; Referees; Research and Analysis Methods; Risk factors; Social Sciences; Thyroid; Hungary; Netherlands; Finland
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0249923

The significance of cardiology screening of referees is not well established. Cardiovascular risk factors and diseases were examined in asymptomatic Hungarian elite handball referees undergoing extended screening: personal/family history, physical examination, 12-lead ECG, laboratory tests, body-composition analysis, echocardiography, and cardiopulmonary exercise testing. Holter-ECG (n = 8), blood pressure monitorization (n = 10), cardiac magnetic resonance imaging (CMR; n = 27) and computer tomography (CCT; n = 4) were also carried out if needed. We examined 100 referees (age: 29.6±7.9years, male: 64, training: 4.3±2.0 hours/week), cardiovascular risk factors were: positive medical history: 24%, overweight: 10%, obesity: 3%, dyslipidaemia: 41%. Elevated resting blood pressure was measured in 38%. Stress-ECG was positive due to ECG-changes in 16%, due to elevated exercise blood pressure in 8%. Echocardiography and/or CMR identified abnormalities in 19%. A significant number of premature ventricular contractions was found on the Holter-ECG in two cases. The CCT showed myocardial bridge or coronary plaques in one-one case. We recommended lifestyle changes in 58%, new/modified antihypertensive or lipid-lowering therapy in 5%, iron-supplementation in 22%. By our results, a high percentage of elite Hungarian handball referees had cardiovascular risk factors or diseases, which, combined with physical and psychological stress, could increase the possibility of cardiovascular events. Our study draws attention to the importance of cardiac screening in elite handball referees.