Echocardiography as a screen to prevent SCD in athletes — 5 Questions with CJSM

 

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Dr. Gian Corrado performing screening cardiac ultrasound

For our first “5 Questions with CJSM” of 2017, we have a special guest:  Dr. Gianmichel Corrado, of Boston Children’s Hospital and Northeastern University.

Dr. Gian Corrado  is a doubly special guest for me: he is the lead author of a ‘published-ahead-of-print’ CJSM study and is someone who trained me in sports medicine at Boston Children’s Hospital.

I have fond memories of working alongside him, the head team physician for Northeastern University in Boston, as we cared for hockey and football athletes.  And I remember the work he was just beginning to do in his now-blossoming area of research.

The new study reports the findings of a novel ‘take’ on a controversial aspect of sports medicine: how might we screen for underlying disorders that predispose our athletes to sudden cardiac death (SCD)?

By the way, don’t let Dr. Gian Corrado’s name fool you — this is not that Dr. Corrado, (Domenico Corrado), who also has published on screening for SCD; but both Drs. Corrado share a similar concern: the primary prevention of this catastrophic event.

Dr. Gian Corrado’s approach is to use ‘screening echocardiography in front-line providers,’ and his findings can be found here:  ‘Early Screening for Cardiovascular Abnormalities with Pre-Participation Echocardiography:  Feasibility Study.’

Dr. Corrado has this to say about his important work:

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1. CJSM: What was the principal outcome measure you were looking at in this study? What were the secondary outcome measures?

GC: Central in the debate as to how to best identify athletes at risk for sudden death (SD) is cost-effectiveness.  The American Heart Association continues to recommend a history and physical (H&P) as the sole method for screening young athletes for the cardiac conditions that can cause SD.  The H&P has been shown to be a poor test to apply to the above dilemma as it misses athletes whom have potentially deadly cardiac conditions and falsely identifies those that do not.  Many feel that, given this reality, an electrocardiogram (ECG) screening program should be implemented.  This approach has been shown to have significant limitations as it too yields high false positive rates.  The Northeastern Group has suggested and demonstrated that with advances in portable ultrasound frontline providers (FLP) can obtain limited echocardiographic images pertinent to the structural conditions that dominate in culpability with SD. Read more of this post

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The CJSM Blog: 2015 in review

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The sun sets on 2015– photo, Kit Yoon

It’s hard to believe 2015 is wrapping up–as I write, it’s already New Year’s Eve in places like Australia and New Zealand, where members of the Australasian College of Sports Physicians [the ‘ACSP,’ one of our affiliated societies] live.

This time of year is one of reflection and thanks.  As I look back on 2015, it is remarkable, I think, to reflect on the many high points this journal enjoyed in its 25th year. The year began with the highly anticipated position statement on musculoskeletal ultrasound, authored by members of the American Medical Society for Sports Medicine [‘AMSSM,’ another one of our affiliated societies].   Mid-year we published a statement that made a huge splash in the research world and the wider, lay media:  the Statement from the proceedings of the 3rd International Exercise-Associated Hyponatremia Consensus Conference.   And we wrapped things up with a controversial study looking at the limitations inherent in screening for sudden-cardiac death in young athletes.

Through it all, we’ve enjoyed our interactions with you, our readers.  Whether on our iPad app, the website, our blog posts and podcasts, or our Twitter feed, we have spent a remarkable year with you.

Thank you.  May you have a wonderful New Year’s, and may 2016 be a professionally fulfilling year for you all.  We look forward to advancing the science of clinical sports medicine with you all.  And before the clock ticks down the final seconds of 2015, we welcome you to see our annual CJSM blog report, below.

Cheers!  See you in 2016!

Here’s an excerpt:

The concert hall at the Sydney Opera House holds 2,700 people. This blog was viewed about 37,000 times in 2015. If it were a concert at Sydney Opera House, it would take about 14 sold-out performances for that many people to see it.

Click here to see the complete report.

#ACSM2015

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Reading #ACSM15 twitter stream, two Fellows of the ACSM: Drs. Anastasia Fischer and Avery Faigenbaum

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Even views from a train are apparently blissful on the California coast.

The 2015 annual meeting of the American College of Sports Medicine has not ended yet, but I’ve had to cut out early.  I’m sad to say I’m on my way from San Diego to L.A. Well, let me clarify my sadness:  I’m on a train heading up the California coast right now, with an absolutely stunning view outside of my window–talk about Exercise is Medicine!  I may not be burning calories while I blog, but there are plenty of surfers in the water this afternoon burning some for me.

No, I’m not sad to still enjoy a little bit of the California ambience.  I’m sad to bid #ACSM15 so long.  It’s been a great conference.

I can only give a superficial nod to all the sessions that have taken place already.  As the world-renowned Australian injury prevention expert Caroline Finch put it in a tweet of hers: “This conference size always stuns me ”

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Drs. Aaron Gray & Jon Patricios, multi-tasking on the dais while talking about the power of social media for sports medicine clinicians.

Dr. Avery Faigenbaum was among a panel of youth sports researchers discussing a new IOC initiative regarding a “Youth Athlete Development Model.”  Pierre d’Hemecourt gave a great, live demonstration of hip ultrasound–I walked away from the session with a renewed sense of the importance of this modality to our profession, a topic CJSM has returned to on several occasions in the journal and on this blog.  Peter Kriz from Brown University gave a hands on demonstration of the clinical use of video analysis in evaluating baseball throwers.  I joined my fellow social media friends, doctors Aaron Gray and Jon Patricios (AKA @MizzouSportsDoc and @JonPatricios) in giving an enjoyable talk on the power of this—of social media in sports medicine.  The power of twitter, for instance, in curating content, in professional networking. The power of podcasting and blogging, whether a producer or user of content.

Of course, there is the socializing at conferences that provides memories as well. I enjoyed a fine diner with Kate Ackerman, the subject of a recent blog post,and Dai Sugimoto,an author of a recent CJSM published study on gender differences in hip abduction/adduction peak torques.

#ACSM15 is not nearly done; there is plenty left today and tomorrow.  But for me, San Diego is well down the train tracks.  Fare well until ACSM 2016 in Boston.  Now that is something to look forward to.

‘Think so vs. Know so’: Dr. Jonathan Finnoff on Sports Ultrasound

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Dr. Jonathan Finnoff delivering Grand Rounds in Columbus, Ohio

Earlier this week I was injecting an ankle:  was I in the joint or not?  I ‘think so’–but with an ultrasound I would ‘know so.’ Perhaps that is all I really need to say in this blog post on sports ultrasound!

Readers of the journal and this blog will be familiar with the Mayo Clinic’s Jonathan Finnoff.  Dr. Finnoff has made substantial contributions to the field of sports ultrasound and most recently was the lead author on a highly cited review of this modality.  I had the chance to interview him and profile this work, an American Medical Society for Sports Medicine position statement, in our December 2014 podcast featuring him.

Dr. Finnoff headed a highly regarded sports ultrasound program at the recent 2015 AMSSM conference in Florida.  I arrived a day late for that, and so could not attend.  Not only did I want to go to that program for its educational value, I wanted to meet the man himself!  As I have written, it is both a wondrous and strange attribute of the modern world to become so engaged with someone on Twitter, or Skype, and yet never meet them in person.

I am happy to say my disappointment was short-lived as the busy doctor was able to come visit Columbus, Ohio yesterday.  I was able to catch the sports medicine grand rounds he delivered at Ohio State and get to shake, at last, the hand that holds the transducer.

Jonathan:  it was good to finally meet you!

If you have never had the chance to hear him speak, make sure you avail yourself of the next opportunity [or listen to the podcast :)]  In the mean time, I wanted to share some of what I came away with from the talk. Read more of this post

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