The role of cardiac computed tomography in sports cardiology: back to the future! . (18th April 2022)

• Record Type: Journal Article
• Authors: D'Ascenzi, Flavio; Baggiano, Andrea; Cavigli, Luna; Mandoli, Giulia Elena; Andreini, Daniele; Marallo, Carmine; Valente, Serafina; Focardi, Marta; Cameli, Matteo; Pontone, Gianluca
• Is Part Of: European heart journal. Volume 23:Number 11(2022)
• Page Start: e481
• Page End: e493
• Publication Date: 2022-04-18
• Subjects: sports cardiology -- coronary artery disease -- myocardial ischaemia -- pre-participation screening -- master athletes; Cardiovascular system -- Imaging -- Periodicals; Heart -- Imaging -- Periodicals; 616.10754
• DOI: 10.1093/ehjci/jeac069
• Languages: English
• ISSNs: 2047-2404

Abstract

Abstract: In recent years, the role of pre-participation evaluation (PPE) in the prevention of sudden cardiac death in competitive athletes has become evident. Most physicians routinely supplement assessment by resting electrocardiogram with imaging techniques, such as echocardiography. The primary goal of imaging in the clinical assessment of competitive athletes is to exclude cardiovascular conditions associated with adverse outcomes. Cardiac computed tomography is emerging as an important technique for stratifying cardiovascular risk and assessing coronary artery disease (CAD), particularly in master athletes. Conversely, in young athletes, this technique has the best non-invasive coronary artery resolution and provides valuable details on coronary artery anatomy. Recent technical developments have brought about a dramatic reduction in radiation exposure, a major drawback of this diagnostic method; nowadays cardiac computed tomography may be performed at a dose of barely one millisievert. The present review provides a practical guide for the use of cardiac computed tomography in the PPE of competitive athletes, with a specific focus on its value for detecting congenital coronary anomalies and CAD in young and master athletes, respectively. Graphical Abstract: Graphical Abstract The figure summarizes the clinical information that can be obtained by coronary computed tomography in sports cardiology, highlighting the differences between young and master athletes.