Magnetic Resonance Imaging–Based Screening Study in a General Population of Adolescents

• Published in: Journal of the American College of Cardiology 2018-02, Vol.71 (5), p.579-580
• Main Authors: Angelini, Paolo, Cheong, Benjamin Y., Lenge De Rosen, Veronica V., Lopez, J. Alberto, Uribe, Carlo, Masso, Anthony H., Ali, Syed W., Davis, Barry R., Muthupillai, Raja, Willerson, James T.
• Format: Article
• Language: English
• Subjects: Adolescents; Age; Cardiology; Cardiomyopathy; Coronary vessels; Electrocardiography; Magnetic resonance imaging; Medical screening; NMR; Nuclear magnetic resonance; Population studies; Teenagers; Veins & arteries; Young adults
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2017.11.051

Improving screening of candidates for participation in sports requires accurate methods of identifying high-risk cardiovascular conditions (hr-CVCs) that predispose young people to sudden cardiac death (SCD). [...]electrocardiography (ECG) can capture some hr-CVCs, but it cannot accurately identify coronary anomalies (3,4) or some cardiomyopathies (CMPs). [...]in a pilot study of a potentially more accurate screening method, we attempted to estimate the prevalence of hr-CVCs in young people by using a screening protocol that involved a questionnaire, resting electrocardiogram, and cardiac magnetic resonance imaging (MRI). Total Cohort (N = 5,243) 11-14 Yrs of Age (n = 4,310) >=15 Yrs of Age (n = 897) n Frequency (%) 95% CI n Frequency (%) n Frequency (%) Any high-risk cardiovascular condition 70 1.34 1.04-1.68 57 1.32 13 1.45 High-risk ACAOS 23 0.44 0.28-0.66 20 0.46 3 0.33 Left ACAOS with intramural course 6 0.11 0.04-0.25 6 0.14 0 0.00 Right ACAOS 17 0.32 0.19-0.52 14 0.32 3 0.33 High-risk cardiomyopathy 14 0.27 0.15-0.45 6 0.14 8 0.89 Dilated cardiomyopathy 11 0.21 0.10-0.38 5 0.12 6 0.67 Hypertrophic cardiomyopathy 3 0.06 0.01-0.17 1 0.02 2 0.22 High-risk electrocardiographic conditions 33 0.63 0.43-0.88 31 0.72 2 0.22 Brugada syndrome 1 0.02 0.00-0.10 0 0.00 1 0.11 Wolff-Parkinson-White syndrome 3 0.06 0.01-0.17 3 0.07 0 0.00 QTc interval >470 ms 29 0.55 0.37-0.79 28 0.65 1 0.11 QTc interval >490 ms 5 0.09 5 0.12 0 1 K.G. Harmon, I.M. Asif, D. Klossner, J.A. Drezner, Incidence of sudden cardiac death in National Collegiate Athletic Association athletes, Circulation, Vol. 123, 2011, 1594-1600 2 T.E. Paterick, M.F. Jan, Z.R. Paterick, Cardiac evaluation of collegiate student athletes: a medical and legal perspective, Am J Med, Vol. 125, 2012, 742-752 3 G. Grazioli, B. Merino, S. Montserrat, Usefulness of echocardiography in preparticipation screening of competitive athletes, Rev Esp Cardiol (Engl Ed), Vol. 67, 2014, 701-705 4 E.S. Yim, F. Basilico, G. Corrado, Early screening for cardiovascular abnormalities with preparticipation echocardiography: utility of focused physician-operated echocardiography in preparticipation screening of athletes, J Ultrasound Med, Vol. 33, 2014, 307-313 5 R.E. Eckart, S.L. Scoville, C.L. Campbell, Sudden death in young adults: a 25-year review of autopsies in military recruits, Ann Intern Med, Vol. 141, 2004, 829-834