Squeo, R;
Ferrera, A; Di Gioia, G; Mango, F; et al;

High blood pressure & cardiovascular prevention :
the official journal of the Italian Society of Hypertension,2025 Mar 14

• Competing Interests: Declarations. Ethical Approval: information: the study design of the present investigation was evaluated and approved by the Ethical Committee (CET – Comitato Etico Territoriale Lazio Area 1, date of approval 06\03\2024 IRB number 0208/2024). All athletes included in this study were fully informed of the types and nature of the evaluation and signed the consent form, according to Italian Law and Institute policy. All clinical data assembled from the study population are maintained in an institutional database. Data Availability: De-identified participant data are available upon reasonable request from the corresponding author. Conflict of interest: None.
• Introduction: Olympic athletes represent a special subset of the athletic population and deserve a specialized medical approach. In view of the 2024 Paris Olympic Games, we developed and implemented a comprehensive medical protocol including (other than the standard screening with ECG, physical and history) cardiopulmonary exercise test, echocardiography and full blood and urine tests.
• Aim: Our aim was to assess the prevalence and type of cardiovascular abnormalities in athletes candidate to Paris 2024 Olympic Games, after implementation of this Olympic medical program.
• Methods: We enrolled 772 elite athletes, who underwent a comprehensive, multidisciplinary evaluation, including full panel of blood and urine tests, electrocardiography, trans-thoracic echocardiography (TTE) and a cardiopulmonary exercise test (CPET).
• Results: Of the 772 elite athletes, 363 (47%) were female. A substantial subset of 145 athletes (18.8%) showed one or more abnormalities. Specifically, either abnormal basal ECG findings (n = 26, 17.9%), abnormal TTE results (n = 45, 31%), high blood pressure (n = 2, 1.4%) or exercise induced arrhythmias (n = 49, 33.8%) were detected. 10 athletes (6.9%) showed both abnormal ECGs and exercise induced arrhythmias, and 13 athletes (9%) showed both ECG and echocardiographic abnormal findings. After further and more detailed investigations, of the 145 athletes showing cardiovascular abnormalities at the initial screening, in 4 of them were cardiac conditions implying potential risk of sudden cardiac death were identified and therefore they were withdrawn from competitive sport. Full blood test analysis identified metabolic abnormalities in 200 subjects. Of these, 165 (21%) showed hypercholesterolemia.
• Conclusions: Olympic athletes, despite the highest level of physical performance, are not exempt from cardiovascular and metabolic diseases, including a small proportion of cardiac conditions at risk of SCD. More advanced diagnostic tools, including CPET, echocardiography and full blood tests, implemented in our protocol, were required to identify hidden cardiovascular abnormalities that could have jeopardized athlete’s health and performance.