Table 3.
Prevalence of potentially high-risk cardiovascular conditions: results from a study of middle-school and high-school adolescents screened with an s-MRI-based protocol.
| Variable | Study population (N = 5,169) |
11–14 years (n = 4310) n (%) |
15–18 years (n = 859) n (%) |
||
|---|---|---|---|---|---|
| n | % (95% CI) | ||||
| Total hr-CVCs | 76 | 1.47 (1.16–1.84) | 62 (1.44) | 14 (1.63) | |
| hr-ACAOS-IM | 23 | 0.44 (0.28–0.67) | 20 (0.46) | 3 (0.35) | |
| L-ACAOS-IM | 6 | 0.12 (0.04–0.25) | 6 (0.14) | 0 (0.00) | |
| RSV | 2 | 0.04 (0.01–0.10) | – | – | |
| NCS | 2 | 0.04 (0.01–0.10) | – | – | |
| High-origin | 2 | 0.04 (0.01–0.10) | – | – | |
| R-ACAOS-IM | 17 | 0.33 (0.19–0.53) | 14 (0.32) | 3 (0.35) | |
| hr-CMP | 14 | 0.27 (0.15–0.45) | 6 (0.14) | 8 (0.93) | |
| DCM* | 11 | 0.21 (0.11–0.38) | 5 (0.12) | 6 (0.70) | |
| HCM | 3 | 0.06 (0.01–0.17) | 1 (0.02) | 2 (0.23) | |
| ECG hr-CVC | 39 | 0.75 (0.54–1.03) | 36 (0.84) | 3 (0.35) | |
| Brugada | 1 | 0.02 (0.00–0.11) | 0 (0.00) | 1 (0.12) | |
| WPW | 4 | 0.08 (0.02–0.20) | 4 (0.09) | 0 (0.00) | |
| QTc ≥ 470 ms | 34 | 0.66 (0.46–0.92) | 32 (0.74) | 2 (0.23) | |
| NCLV* | 959 | 18.55 (17.5–19.64) | 810 (18.79) | 149 (17.35) | |
ACAOS-IM, anomalous origin of coronary artery from the opposite sinus of Valsalva with intramural course; CMP, cardiomyopathy; CVC, cardiovascular condition; DCM, dilated cardiomyopathy; ECG, electrocardiographic; HCM, hypertrophic cardiomyopathy; hr, high-risk; L-ACAOS-IM, left ACAOS from the right sinus with intramural course; NCLV, noncompaction left ventricle; NCS, noncoronary sinus; R-ACAOS, right ACAOS; RSV, right sinus of Valsava; WPW, Wolff-Parkinson-White anomaly.
Adapted with permission from Angelini P, Cheong BY, Lenge De Rosen VV, Lopez A, Uribe C, Masso AH, Ali SW, Davis BR, Muthupillai R, Willerson JT. High-risk cardiovascular conditions in sports-related sudden death: prevalence in 5,169 schoolchildren screened via cardiac magnetic resonance. Tex Heart Inst J. 2018;45:205–213 [3].
Isolated NCLV by Petersen’s criteria is not likely to be a high-risk condition in the young. In these 2 large cohorts (continuous series in 2 age groups: only the prevalence of CMP is different because of the apparent increase in DCM in the older adolescents (p value <0.01*). See Table 2 for aggregate results. As the origin and initial course of CAAs were well described in 99% of the MRI studies, the impact of potential false-positive and false-negative reporting could only be possible to validate by using autopsy data from the same subjects who die after MRI [2].