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Introduction <p>Olympic athletes represent a special subset of the athletic population and deserve a specialized medical approach. In view of the 2024 Paris Olympic Games, we developed and implemented a comprehensive medical protocol including (other than the standard screening with ECG, physical and history) cardiopulmonary exercise test, echocardiography and full blood and urine tests.</p> Aim <p>Our aim was to assess the prevalence and type of cardiovascular abnormalities in athletes candidate to Paris 2024 Olympic Games, after implementation of this Olympic medical program.</p> Methods <p>We enrolled 772 elite athletes, who underwent a comprehensive, multidisciplinary evaluation, including full panel of blood and urine tests, electrocardiography, trans-thoracic echocardiography (TTE) and a cardiopulmonary exercise test (CPET).</p> Results <p>Of the 772 elite athletes, 363 (47%) were female. A substantial subset of 145 athletes (18.8%) showed one or more abnormalities. Specifically, either abnormal basal ECG findings (<i>n</i> = 26, 17.9%), abnormal TTE results (<i>n</i> = 45, 31%), high blood pressure (<i>n</i> = 2, 1.4%) or exercise induced arrhythmias (<i>n</i> = 49, 33.8%) were detected. 10 athletes (6.9%) showed both abnormal ECGs and exercise induced arrhythmias, and 13 athletes (9%) showed both ECG and echocardiographic abnormal findings. After further and more detailed investigations, of the 145 athletes showing cardiovascular abnormalities at the initial screening, in 4 of them were cardiac conditions implying potential risk of sudden cardiac death were identified and therefore they were withdrawn from competitive sport. Full blood test analysis identified metabolic abnormalities in 200 subjects. Of these, 165 (21%) showed hypercholesterolemia.</p> Conclusions <p>Olympic athletes, despite the highest level of physical performance, are not exempt from cardiovascular and metabolic diseases, including a small proportion of cardiac conditions at risk of SCD. More advanced diagnostic tools, including CPET, echocardiography and full blood tests, implemented in our protocol, were required to identify hidden cardiovascular abnormalities that could have jeopardized athlete’s health and performance.</p>

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Pre-participation Cardiovascular Evaluation for Paris 2024 Olympic Games in Elite Athletes: The Italian Experience

  • 期刊论文

  • 发表日期：

    2025年3月14日

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  • Maria Rosaria Squeo,
  • Armando Ferrera,
  • Giuseppe Di Gioia,
  • Federica Mango,
  • Viviana Maestrini,
  • Sara Monosilio,
  • Erika Lemme,
  • Simone Crotta,
  • Alessandro Spinelli,
  • Andrea Serdoz,
  • Roberto Fiore,
  • Domenico Zampaglione,
  • Cosimo Damiano Daniello,
  • Massimo Volpe,
  • Marco Bernardi,
  • Antonio Pelliccia

摘要

Introduction

Olympic athletes represent a special subset of the athletic population and deserve a specialized medical approach. In view of the 2024 Paris Olympic Games, we developed and implemented a comprehensive medical protocol including (other than the standard screening with ECG, physical and history) cardiopulmonary exercise test, echocardiography and full blood and urine tests.

Aim

Our aim was to assess the prevalence and type of cardiovascular abnormalities in athletes candidate to Paris 2024 Olympic Games, after implementation of this Olympic medical program.

Methods

We enrolled 772 elite athletes, who underwent a comprehensive, multidisciplinary evaluation, including full panel of blood and urine tests, electrocardiography, trans-thoracic echocardiography (TTE) and a cardiopulmonary exercise test (CPET).

Results

Of the 772 elite athletes, 363 (47%) were female. A substantial subset of 145 athletes (18.8%) showed one or more abnormalities. Specifically, either abnormal basal ECG findings (n = 26, 17.9%), abnormal TTE results (n = 45, 31%), high blood pressure (n = 2, 1.4%) or exercise induced arrhythmias (n = 49, 33.8%) were detected. 10 athletes (6.9%) showed both abnormal ECGs and exercise induced arrhythmias, and 13 athletes (9%) showed both ECG and echocardiographic abnormal findings. After further and more detailed investigations, of the 145 athletes showing cardiovascular abnormalities at the initial screening, in 4 of them were cardiac conditions implying potential risk of sudden cardiac death were identified and therefore they were withdrawn from competitive sport. Full blood test analysis identified metabolic abnormalities in 200 subjects. Of these, 165 (21%) showed hypercholesterolemia.

Conclusions

Olympic athletes, despite the highest level of physical performance, are not exempt from cardiovascular and metabolic diseases, including a small proportion of cardiac conditions at risk of SCD. More advanced diagnostic tools, including CPET, echocardiography and full blood tests, implemented in our protocol, were required to identify hidden cardiovascular abnormalities that could have jeopardized athlete’s health and performance.