The young athlete's heart: An electrocardiographic challenge

Bram Bessem

The young athlete's heart: An electrocardiographic challenge

Bram Bessem

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Het plots overlijden van een sporter is een zeer aangrijpende gebeurtenis! Als een jonge sporters plots komt te overlijden ligt hier meestal een onderliggend hartafwijking aan ten grondslag. Om te proberen de acute hartdood van een jonge sporter te voorkomen is er in 2006 een voorstel gedaan voor een preventieve hartscreening; de Lausanne aanbevelingen. Een belangrijk onderdeel van deze screening is het hartfilmpje (ECG) van de sporter. Om te proberen onderscheid te maken tussen normale ECG bevindingen bij sporters en bevindingen die mogelijk passen bij een onderliggende hartspierziekte, zijn er sinds 2006 zes vernieuwingen van de ECG criteria verschenen (laatste versie 2017; Internationale criteria). Met dit proefschrift willen we nieuwe inzichten vergaren in de impact van de invoering van de verschillende ECG criteria in onze populatie. Ook willen we kijken naar de impact van verschillende karakteristieken van de sporter op het ECG en de consequenties hiervan voor de hartscreening. In dit proefschrift worden de resultaten beschreven van de invoering van verschillende ECG criteria in onze populatie. Ook wordt er beschreven wat de impact is van de leeftijd, het geslacht en de hoeveelheid sport blootstelling van de sporters op hun ECG. We concluderen daarmee dat we momenteel nog steeds ongedifferentieerde normaalwaarde referenties gebruiken, terwijl er veel aanwijzingen zijn dat er op basis van de karakteristieken van de sporter er verschillende normaal verdelingen zijn. We adviseren dan ook het gebruik van een meer gepersonaliseerde vorm van geneeskunde waarbij normaal waardes meer gedifferentieerd zijn en meer passend bij de karakteristieken van de patiënt/sporter.

Originele taal-2	English
Kwalificatie	Doctor of Philosophy
Toekennende instantie	Rijksuniversiteit Groningen
Begeleider(s)/adviseur	Zwerver, Hans, Supervisor van den Berg, Maarten, Supervisor Nieuwland, Wybe, Co-supervisor
Datum van toekenning	4-okt.-2017
Plaats van publicatie	[Groningen]
Uitgever	Rijksuniversiteit Groningen
Gedrukte ISBN's	978-94-034-0031-0
Elektronische ISBN's	978-94-034-0032-7
Status	Published - 2017

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Title and contentsFinal publisher's version, 1 MB
Chapter 1Final publisher's version, 1,52 MB
Chapter 2Final publisher's version, 1,82 MB
Chapter 3Final publisher's version, 1,76 MB
Chapter 4Final publisher's version, 1,47 MB
Chapter 5Final publisher's version, 1,66 MB
Chapter 6Final publisher's version, 1,61 MB
Chapter 7Final publisher's version, 1,28 MB
SummaryFinal publisher's version, 1,21 MB
Nederlandse samenvattingFinal publisher's version, 1,21 MB
DankwoordFinal publisher's version, 1,12 MB
Curriculum Vitae and List of publicationsFinal publisher's version, 476 KB
Complete thesisFinal publisher's version, 2,54 MB
PropositionsFinal publisher's version, 180 KB

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title = "The young athlete's heart: An electrocardiographic challenge",

abstract = "The sudden cardiac death (SCD) of a young athlete is a catastrophic event. To try to prevent a young SCD the Lausanne cardiac screening protocol has been proposed in 2006. One of the main foci is the electrocardiogram (ECG) of the athlete. To try to differentiate between normal ECG findings in athletes and ECG findings that could be a signs of possible underlying cardiac pathology, six ECG criteria have been proposed since 2006 with the latest published in 2017 (International criteria). With this thesis we wanted to study the impact of the different ECG criteria on our population and of the individual characteristic on athletes{\textquoteright} ECG and their consequences for cardiac screening. In this thesis results of the use of different ECG criteria in our population are presented. Also the impact of the athlete{\textquoteright}s characteristics age, sex and sport exposure on their ECG are studied. We concluded that we still use many rather undifferentiated ranges of reference values while there is increasing evidence for different norm distribution based on patients{\textquoteright} or athletes{\textquoteright} characteristics. We therefore recommended a form of personalised medicine in which norm values are more differentiated and more individualised to fit the patient and/or athlete.",

author = "Bram Bessem",

year = "2017",

language = "English",

isbn = "978-94-034-0031-0",

publisher = "Rijksuniversiteit Groningen",

school = "University of Groningen",

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T1 - The young athlete's heart

T2 - An electrocardiographic challenge

AU - Bessem, Bram

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AB - The sudden cardiac death (SCD) of a young athlete is a catastrophic event. To try to prevent a young SCD the Lausanne cardiac screening protocol has been proposed in 2006. One of the main foci is the electrocardiogram (ECG) of the athlete. To try to differentiate between normal ECG findings in athletes and ECG findings that could be a signs of possible underlying cardiac pathology, six ECG criteria have been proposed since 2006 with the latest published in 2017 (International criteria). With this thesis we wanted to study the impact of the different ECG criteria on our population and of the individual characteristic on athletes’ ECG and their consequences for cardiac screening. In this thesis results of the use of different ECG criteria in our population are presented. Also the impact of the athlete’s characteristics age, sex and sport exposure on their ECG are studied. We concluded that we still use many rather undifferentiated ranges of reference values while there is increasing evidence for different norm distribution based on patients’ or athletes’ characteristics. We therefore recommended a form of personalised medicine in which norm values are more differentiated and more individualised to fit the patient and/or athlete.

M3 - Thesis fully internal (DIV)

SN - 978-94-034-0031-0

PB - Rijksuniversiteit Groningen

CY - [Groningen]

ER -

The young athlete's heart: An electrocardiographic challenge

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