Document Detail

Exercise-related syncope in young competitive athletes without evidence of structural heart disease. Clinical presentation and long-term outcome.
MedLine Citation:
PMID:  12090751     Owner:  NLM     Status:  MEDLINE    
AIMS: Exercise-related syncopal spells in athletes receive great attention and are a source of anxiety in the sporting world. The aim of the present study is to describe the clinical presentation, the yield of the initial diagnostic work-up and the long-term outcome of a series of consecutive competitive athletes with recurrent exercise-related syncopal spells. METHODS AND RESULTS: The study cohort included 33 athletes (20 females, mean age 21.4+/-3.2 years) referred for recurrent unexplained episodes of exercise-related syncope (mean number of spells before evaluation 4.66+/-1.97). All athletes underwent an extensive evaluation, including echocardiography, 24-h electrocardiographic monitoring, exercise testing, cardiac electrophysiological study and head-up tilt testing. The echocardiographic examination revealed the presence of a mitral valve prolapse in two cases (6.0%). During maximal exercise testing, four athletes (12.1%) developed hypotension associated with pre-syncope. Twenty-two subjects (66.6%) showed a positive response to head-up tilt testing. During follow-up (33.5+/-17.2 months) 11/33 athletes (33.3%) showed at least one recurrence of exercise-related syncope (mean time to first recurrence 20.4+/-14.5 months). No other adverse event of any kind was noted during follow-up. The Kaplan-Meier estimates of first recurrence of exercise-related syncope after 12, 36 and 60 months were 9.1%, 24.4% and 42.9%. The number and frequency of exercise-related syncopal spells before evaluation were found to be univariate predictors of syncope recurrence (P<0.001). However, in the multivariate analysis, the number of exercise-related syncopal spells before evaluation was found to be the only independent predictor of syncope recurrence (P<0.05). CONCLUSIONS: These findings support the idea that recurrent exercise related-syncope is not associated with an adverse outcome in athletes without cardiac disease.
F Colivicchi; F Ammirati; A Biffi; L Verdile; A Pelliccia; M Santini
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European heart journal     Volume:  23     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-07-01     Completed Date:  2002-10-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  1125-30     Citation Subset:  IM    
Copyright Information:
Copyright 2002 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved.
Division of Cardiology, 'S. Filippo Neri' Hospital, Rome, Italy.
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MeSH Terms
Analysis of Variance
Cardiovascular System
Cohort Studies
Exercise Test
Predictive Value of Tests
Reference Values
Risk Assessment
Syncope / diagnosis*,  epidemiology,  etiology*
Tilt-Table Test
Comment In:
Eur Heart J. 2003 Apr;24(8):783; author reply 783-4   [PMID:  12713771 ]
Eur Heart J. 2003 Feb;24(3):289; author reply 289   [PMID:  12590907 ]
Eur Heart J. 2002 Jul;23(14):1080-2   [PMID:  12090744 ]

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