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Published on June 08, 2011

LMH Cardiologist Michael Zabel on Team of Researchers Recommending Cardiac Screening


LMH Cardiologist Michael Zabel and team recommending pre-participation cardiac screening for college athletics.


Research published in the June issue of The American Journal of Medicine recommending pre-participation cardiac screening for college athletes has a Lawrence connection.

Lawrence cardiologist Michael Zabel, MD, was one of the researchers from Lawrence Memorial Hospital, Saint Luke’s Mid America Heart and Vascular Institute, Kansas City, Mo., and the University of Kansas, Lawrence, who screened 964 male and female varsity KU athletes for cardiac health. In addition to following the American Heart Association/American College of Cardiology guidelines for pre-participation screening for competitive collegiate athletes, electrocardiograms (ECG) and echocardiograms were added to the testing.

Sudden cardiac death in young athletes who had not previously exhibited symptoms is a relatively rare yet tragic event. This occurs in approximately 60-80 young athletes annually in the United States

Dr. Zabel stated, “It is such a tragedy when an athlete dies unexpectedly during or after a competitive event. We feel it is important to determine the most effective and efficient way to screen these athletes in order to decrease their risk.”

The research found that distinct ECG abnormalities were present in 10% and were more common in males as well as black athletes. Two athletes were subsequently excluded from competition.

The KU athletes represented 14 competitive sports with football comprising about 25% of the subjects, rowing 18% and track and field 16%. Close to 9% of all subjects reported a family history of premature death and nearly 15% reported symptoms. Almost 23% of all athletes met the current guidelines for further cardiac testing.

The study found that male athletes were nearly three times more likely to have distinctly abnormal ECG patterns, while mildly abnormal patterns were similar in males and females. Black athletes were more than twice as likely to have distinctly abnormal ECG patterns, and even after adjusting for sex and body mass index, blacks were still 70 to 80% more likely to show these patterns.

The authors point to three novel findings resulting from the study: First, adherence strictly to the guidelines for pre-participation screening identified nearly one quarter of athletes who were candidates for non-invasive cardiovascular screening based on history or symptoms. Second, ECG findings revealed clinically important electrical abnormalities in nearly 1% of the cohort, including eight athletes with previously unrecognized conditions. Third, although black race was independently associated with a greater prevalence of distinctly abnormal ECG patterns, clinically important racial differences in cardiac structure were not apparent.

“I am happy to be involved in this important research,” Dr. Zabel said. “This is an ongoing project and collaboration between Cardiovascular Specialists of Lawrence, Kansas University and the Mid-America Heart Institute.”

The article is "Cardiovascular Screening with Electrocardiography and Echocardiography in Collegiate Athletes" by Anthony Magalski, MD, Marcia McCoy, RN, MSN, Michael Zabel, MD, Lawrence M. Magee, MD, Joseph Goeke, MD, Michael L. Main, MD, Linda Bunten, RN, BSN, Kimberly J. Reid, MS, and Brian M. Ramza, MD, PhD. It appears in The American Journal of Medicine, Volume 124, Issue 6 (June 2011) published by Elsevier.

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