Heart Screenings Yield More False-Positives Among Black Athletes
Race-specific screening criteria needed, researchers say
TUESDAY, March 27, 2012 (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.
The U.S. National Center for Sports Safety provides more information on heart disease in athletes.