Significance of extended sports cardiology screening of elite handball referees

The routine screening of athletes, being as a useful method of preventing the formation or progression of many cardiovascular (CV) diseases, is widely considered valuable. Although referees have similar physical and mental load as athletes during matches, only little data is available on the prevalence of CV risk factors and pathologies in referees. Therefore, the aim of the Heart and Vascular Center of Semmelweis University was to perform an extensive screening of elite handball referees: physical examination, blood pressure measurement, body composition analysis, echocardiographic examination, spiroergometry examination and further examinations when required.

The study features the results of 100 elite handball referees (age: 29.6±7.9 years, male: 64, training: 4.3±2.0 hours/week). In terms of the CV risk factors or diseases, 24% had positive personal or family history, 11% were overweight, whereas obesity was diagnosed in 3%. 15% had increased serum cholesterol levels, 20% showed higher LDL cholesterol values. Elevated resting blood pressure was measured in 38%. Stress-ECG was positive due to ECG-changes in 16%, due to elevated exercise blood pressure in 8%. Echocardiography and/or CMR identified abnormalities in 19%. Ventricular aryhtmia was found on the HolterECG in one case. The CCT showed myocardial bridge or coronary plaques in one-one case. We recommended lifestyle changes in 34%, new/modified antihypertensive or lipid-lowering therapy in 4%, iron-supplementation in 21% of the cases.

The results have shown that a high percentage of elite Hungarian handball referees had cardiovascular risk factors or diseases, which, combined with physical and psychological stress, could increase the possibility of cardiovascular events.

“The study draws attention to the importance of cardiac screening, patient monitoring and the importance of treatment in elite handball referees,” summarized dr. Máté Babity, PhD student of the Sport Cardiology Working Group of the Heart and Vascular Center.