Jonathan A Drezner's research while affiliated with Washington State University and other places
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Publications (256)
Objective
Concerns for cardiac involvement after SARS-CoV-2 infection led to widespread cardiac testing in athletes. We examined incidental non-COVID-19 cardiovascular pathology in college athletes undergoing postinfection return-to-play screening.
Methods
The Outcomes Registry for Cardiac Conditions in Athletes was a nationwide prospective multic...
Background
Clinical practice recommendations for participation in sports and exercise among young competitive athletes with cardiovascular conditions at risk for sudden death are based largely on expert consensus with a paucity of prospective outcomes data. Recent guidelines have taken a more permissive approach, using a shared decision‐making mode...
Background
While young adults 18–24 years old bear a significant proportion of COVID-19 diagnoses, the risk factors for hospitalisation and severe COVID-19 complications in this population are poorly understood.
Objective
The objective of this study was to identify risk factors for hospitalisation and other COVID-19 complications across the health...
Aims:
This study aimed to report the long-term findings of the Italian programme of cardiovascular preparticipation screening (PPS) in young, competitive athletes.
Methods and results:
The study assessed the diagnostic yield for diseases at risk of sudden cardiac death (SCD), the costs of serial evaluations, and the long-term outcomes of PPS in...
The Outcomes Registry for Cardiac Conditions in Athletes (ORCCA) study is a large-scale prospective investigation evaluating the cardiovascular effects and outcomes of SARS-CoV-2 infection on young competitive athletes. This review provides an overview of the key results from the ORCCA study. Results from the ORCCA study have provided important ins...
Objective
To evaluate the psychological implications of cardiovascular preparticipation screening (PPS) in athletes.
Design
Systematic review.
Data sources
MEDLINE, EMBASE, PubMed, CINAHL, SPORTDiscus, APA PsycInfo, Cochrane Library and grey literature sources.
Study eligibility criteria
Observational and experimental studies assessing a populat...
Preparticipation cardiovascular screening (PPCS) in young athletes is performed to detect conditions associated with sudden cardiac death. Many medical societies and sports governing bodies support the addition of a 12-lead electrocardiogram (ECG) to the history and physical to improve PPCS sensitivity. The current standard for ECG interpretation i...
Objective:
To examine sudden cardiac arrest (SCA) awareness and emergency preparedness for SCA in Amateur Athletic Union (AAU) youth basketball teams.
Design:
Cross-sectional survey of AAU coaches and administrators.
Setting:
Random sampling of AAU club teams across the United States.
Participants:
AAU club coaches and/or administrators.
In...
Background
Cardiac screening of elite athletes including a 12‑lead electrocardiogram (ECG) is recommended by numerous international bodies. Current athlete ECG interpretation guidelines recommend the Bazett method to correct the QT interval (QTc).
Objective
This study sought to investigate normative QTc changes by age using athlete screening ECGs...
Sudden cardiac adverse events remain an area of concern in sport. The precise risk for netball athletes is unknown but the annual incidence of sudden cardiac death in sports is reported at 0.5-2 cases in 100 000 young competitive athletes between the ages of 12-35 years. Cardiac screening in the sport and exercise medicine context aims at identifyi...
Preparticipation cardiovascular screening, designed to identify cardiovascular pathology responsible for sudden unexpected death, is recommended by all major professional medical organizations overseeing the clinical care of competitive athletes. Data from several large, prospective, cohort studies indicate that cardiac imaging findings consistent...
Aims
Low QRS voltages (peak to peak <0.5 mV) in limb leads (LQRSV) on the athlete’s electrocardiogram (ECG) may reflect an underlying cardiomyopathy, mostly arrhythmogenic cardiomyopathy (ACM) or non-ischaemic left ventricular scar (NILVS). We studied the prevalence and clinical meaning of isolated LQRSV in a large cohort of competitive athletes.
M...
Initial guidelines recommended a 12-lead electrocardiogram (ECG) in young competitive athletes following SARS-CoV-2 infection to screen for myocarditis. However, no data are available that detail ECG findings before and after SARS-CoV-2 infection in young athletes without clinical or imaging evidence of overt myocarditis. This study applied the Int...
Regular physical activity provides a variety of health benefits and is proven to treat and prevent several non-communicable diseases. Specifically, physical activity enhances muscular and osseous strength, improves cardiorespiratory fitness, and reduces the risk of hypertension, coronary heart disease, stroke, type 2 diabetes, mental health disorde...
The primary objective of preparticipation cardiovascular evaluation (PPCE) in young athletes is to detect asymptomatic individuals with cardiovascular disease (CVD) at risk of sudden cardiac death (SCD). The study population included a consecutive series of competitive athletes age 12–18 years who underwent PPCE, which according to Italian law is m...
Objective
To assess the prevalence and clinical implications of persistent or exertional cardiopulmonary symptoms in young competitive athletes following SARS-CoV-2 infection.
Methods
This observational cohort study from the Outcomes Registry for Cardiac Conditions in Athletes included 3597 US collegiate athletes after SARS-CoV-2 infection. Clinic...
Objective
Minority student-athletes have a lower survival rate from sudden cardiac arrest (SCA) than non-minority student-athletes. This study examined the relationship between high school indicators of socioeconomic status (SES) and survival in student-athletes with exercise-related SCA.
Methods
High school student-athletes in the USA with exerci...
The Task Force on sports cardiology and exercise in patients with cardiovascular disease of the European Society of Cardiology (ESC)
Objective:
To compare the prevalence and risk factors for hypertension (HTN) in college athletes using the new (≥130/80 mm Hg) versus prior (≥140/90 mm Hg) US hypertension guidelines.
Design:
Retrospective cohort study.
Setting:
Eleven Pacific-12 Conference institutions.
Participants:
Of the 8602 athletes enrolled in the primary study, 4977...
Background: Cardiac involvement among hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is common and associated with adverse outcomes. The objective of this study was to determine the prevalence and clinical implications of SARS-CoV-2 cardiac involvement in young competitive athletes.
Methods: In this prospect...
Context
Limited data are available to guide cardiovascular screening in adult or masters athletes (≥35 years old). This review provides recommendations and the rationale for the cardiovascular risk assessment of older athletes.
Evidence Acquisition
Review of available clinical guidelines, original investigations, and additional searches across Pub...
In this brief report, we describe the safety of reopening US Olympic and Paralympic Training facilities (USOPTFs) during the coronavirus disease 2019 (COVID-19) pandemic from July 2020 through October 2020. We evaluated the prevalence of COVID-19 infection at the time of reentry and cardiopulmonary sequelae of COVID-19 in elite athletes. All athlet...
The diagnosis of a potentially lethal cardiovascular disease in a young athlete presents a complex dilemma regarding athlete safety, patient autonomy, team or institutional risk tolerance and medical decision-making. Consensus cardiology recommendations previously supported the ‘blanket’ disqualification of athletes with hypertrophic cardiomyopathy...
Objectives
We assessed whether the presence and character of a cardiac murmur in adolescents were associated with structural heart disease that confers risk of sudden cardiac death (SCD).
Methods
We performed a retrospective analysis of 15 141 adolescents age 12–19 who underwent a heart screen with history, physical examination and ECG. Participan...
Introduction: Coronary artery calcium (CAC) is a robust predictor of coronary events in asymptomatic individuals with latent atherosclerotic cardiovascular disease (CVD). While evidence suggests CAC scoring may augment traditional CVD risk scores in clinical decision making, evidence is limited on the compared ability of CVD risk scores to identify...
Objective
To investigate the aetiology and incidence of sudden cardiac arrest and death (SCA/D) in US competitive athletes.
Methods
Prospective surveillance was conducted from 1 July 2014 to 30 June 2018 through the National Center for Catastrophic Sports Injury Research in collaboration with national sports organisations. Autopsy reports, death c...
Sudden cardiac death (SCD) is the leading cause of fatalities in competitive athletes during sports and exercise. SCD is caused by a variety of congenital and genetic cardiac conditions, including cardiomyopathies, channelopathies, anomalous coronary arteries, and aortic dissection. Epidemiologic evidence suggests that basketball athletes are at hi...
Background
Electrocardiogram (ECG) screening in athletes enhances the detection of conditions associated with sudden cardiac death (SCD), but concerns remain for false positive results when conducted outside of specialized centers. This study compared ECG interpretation in college athletes between local physicians and a sports cardiology center (SC...
Sudden cardiac arrest (SCA) is the leading cause of exercise-related fatalities in athletes. A comprehensive emergency action plan (EAP) is critical to facilitate a rapid and effective response to a cardiac emergency. SCA should be suspected in any athlete that collapses suddenly and is unresponsive. All potential responders to a collapsed athlete...
Background
Preparticipation screening for conditions associated with sudden cardiac death (SCD) is required in college athletes. Prior cost analyses use theoretical models based on variable assumptions; but no study uses real-life outcomes.
Objective
To compare disease prevalence, positive findings and costs of two different screening strategies:...
Sudden cardiac death (SCD) is the leading cause of sudden death in athletes during sports and exercise, and electrocardiogram (ECG) abnormalities are present in the majority of conditions associated with SCD. Whether used for screening or diagnostic purposes, proper ECG interpretation is a fundamental skill for physicians responsible for the cardio...
Background
Sickle cell trait (SCT) has been associated with an increased risk of sudden death in athletes during strenuous exercise. In August 2010, the National Collegiate Athletic Association (NCAA) began requiring athletes to be screened for SCT, provide proof of SCT status, or sign a waiver and launched an educational campaign for athletes, coa...
Pre‐participation cardiovascular screening (PPCS) is recommended by several scientific and sporting organizations on the premise that early detection of cardiac disease provides a platform for individualized risk assessment and management; which has been proven to lower mortality rates for certain conditions associated with sudden cardiac arrest (S...
With great interest we read the paper by Arne Janssen and colleagues.1 We commend the authors for raising awareness within the preventive cardiology community for non-alcoholic fatty liver disease (NAFLD) and its emerging role as a risk indicator for atherosclerotic cardiovascular disease (ASCVD). The implication of this new understanding is to pur...
Background
Asthma is prevalent in athletes and when left untreated is recognised to impact health and performance. Prior research highlights the presence of asthma-related mortality associated with sport, however, this data is now almost twenty years old¹ and both treatment and mortality patterns have evolved over this time. Indeed the Royal Colleg...
Primary care clinicians fulfill critical roles of screening for, diagnosing, and managing cardiovascular disease. In young athletes, primary structural and electrical diseases are the focus. Coronary artery disease is the chief concern in older athletes. Sudden cardiac arrest may be the initial presentation of disease and is more common in young at...
Although premature ventricular beats (PVBs) in young people and athletes are usually benign, they may rarely mark underlying heart disease and risk of sudden cardiac death during sport. This review addresses the prevalence, clinical meaning and diagnostic/prognostic assessment of PVBs in the athlete. The article focuses on the characteristics of PV...
Background
Preparticipation cardiovascular screening in athletes is fully endorsed by major medical societies, yet the most effective screening protocol remains debated. We prospectively compared the performance of the American Heart Association ( AHA ) 14‐point screening evaluation and a resting ECG for cardiovascular screening of high school athl...
Background:
Accurate electrocardiogram (ECG) interpretation in competitive athletes requires the distinction of physiological adaptations from findings suggestive of a pathological condition. The purpose of this study was to compare the performance of the Seattle Criteria to the International Criteria in a large dataset of NCAA athletes screened w...
Sudden cardiac death (SCD) is the leading cause of fatalities in competitive athletes during sports and exercise. These tragic events often receive intense public attention and stimulate debate regarding the most appropriate prevention strategies. A precise understanding of SCD incidence is needed to guide effective screening programmes and proper...
Sport and exercise have been intensely advocated as protective lifestyle measures, preventing or reducing the risk of severe health issues including cardiovascular disease. More extreme forms of sport (for instance at high altitudes) have been identified as an important way of promoting cardiovascular adaptation, but have also been associated with...
Mass participation endurance sports events are popular but a large number of participants are older and may be at risk of medical complications during events. Medical encounters (defined fully in the statement) include those traditionally considered ‘musculoskeletal’ (eg, strains) and those due to ‘illness’ (eg, cardiac, respiratory, endocrine). Th...
Introduction: The death of young athletes is devastating to families and communities. Despite routine pre-participation screening, 80–100/yr die or suffer cardiac arrest, with 65% occurring in high school athletes. AHA/ACC recommendations for pre-participation screening do not include routine electrocardiogram (ECG), in contrast to some internation...
Current definitions of an athlete range from loosely defined to overly restrictive, rely on qualitative subjective descriptors, and fail to capture the majority of physically active patients. To improve the understanding between exercise and health metrics a more standardized and granular classification of exercising patients is required. We propos...
Background:
Sudden cardiac arrest (SCA) is the leading cause of death in young athletes during sports.
Hypothesis:
Survival after SCA in young athletes is variable.
Study design:
Prospective, active surveillance study.
Level of evidence:
Level 3.
Methods:
From July 1, 2014, to June 30, 2016, exercise-related SCA in competitive young athlet...
To assess the accuracy of interpreting the athlete’s ECG both pre and post a series of online training modules among a range of healthcare professionals. 10 512 healthcare professionals from 138 different nations commenced the online course. These were primarily doctors (43%), nurses (18.4%) and other healthcare professionals (3.9%). The users came...
Background: The development of athlete-specific electrocardiogram (ECG) interpretation standards, along with recent rates of sudden cardiac death (SCD) in athletes being higher than previously estimated, has heightened the debate in the sports medicine community regarding cardiovascular screening of the college athlete, including whether certain hi...
Appendix, DS_10.1177_1941738118775039 – Cardiovascular Screening Practices and Attitudes From the NCAA Autonomous “Power” 5 Conferences
Objective:
To determine the etiology of sudden cardiac arrest and death (SCA/D) in competitive athletes through a prospective national surveillance program.
Design:
Sudden cardiac arrest and death cases in middle school, high school, college, and professional athletes were identified from July 2014 to June 2016 through traditional and social med...
Sudden cardiac arrest remains the leading cause of death in exercising athletes, and recent studies have shown that it occurs more frequently than historical estimates. While out-of-hospital cardiac arrest often proves fatal, advance preparation can improve outcomes and the chance of survival. First responders to a collapsed athlete on the field of...
Regular physical activity is associated with numerous health benefits, including lower cardiovascular and total morbidity and mortality. Paradoxically, intense physical activity is associated with an increased risk of serious cardiac events, including sudden cardiac arrest/death (SCA/SCD), especially in subjects with an underlying (also subclinical...
Sudden cardiac death (SCD) is the leading cause of medical death in athletes with an estimated rate of 1 in 50,000, with higher risk in some subgroups including males, African Americans, and male basketball athletes. A thorough understanding of the epidemiology of sudden cardiac arrest and SCD in athletes is important as well as familiarity with sc...
Background:
Because sudden cardiac death (SCD) in the young mainly occur in individuals with structurally normal hearts, improved screening techniques for detecting inherited arrhythmic diseases are needed. The QT interval is an important screening measurement; however, the criteria for detecting an abnormal QT interval are based on Bazett formula...