Aims 

Identification of silent cardiovascular diseases by preparticipation evaluation (PPE) and disqualification from competitive sports have the potential to prevent sudden death but may induce adverse psychological consequences, particularly for exercise addicted athletes. We investigated the relationship between exercise addiction, attitude towards PPE and reaction to cardiovascular disease diagnosis.

Methods 

We invited Italian competitive athletes to participate in an online questionnaire investigating exercise addiction, opinion about mandatory PPE and potential reaction to both sports disqualification and hypothetical diagnosis of different cardiovascular diseases.

Results 

The survey was completed by 1011 athletes (75% men, median age 30 years) encompassing a wide range of sports disciplines and competition levels. According to the ‘Exercise Dependence Scale-21’, 6% were classified as exercise addicted. The vast majority of both exercise addicted and nonexercise addicted athletes agreed that PPE should be mandatory (92 and 96%, P = 0.17) and that the eligibility decision should be left to the sports medicine physician (82 and 89%, P = 0.08). In case a cardiovascular disease is identified, a higher proportion of exercise addicted athletes would undergo ‘open-heart’ surgery if this would allow resuming high-intensity sport (54 versus 31%, P < 0.001) and would continue exercising in case of diagnosis of a disease at risk of sudden death (57 versus 32%, P < 0.001).

Conclusion 

Exercise addiction does not interfere with a general positive opinion about PPE, but is likely to impact on the adherence to medical prescription should a cardiovascular diagnosis be made. Exercise addiction should be taken into account when counselling athletes with newly diagnosed heart diseases.

中文翻译：

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运动成瘾对参加前评估和遵守医学处方态度的影响

目的 

通过参加前评估（PPE）识别无声心血管疾病和取消竞技运动资格可能有预防猝死的潜力，但可能会引起不良的心理后果，尤其是对运动成瘾的运动员。我们调查了运动成瘾，对个人防护装备的态度以及对心血管疾病诊断反应之间的关系。

方法 

我们邀请意大利竞技运动员参加在线问卷，调查运动成瘾，对强制性PPE的看法以及对运动不合格和对各种心血管疾病的假想诊断的潜在反应。

结果 

这项调查由1011位运动员（75％的男性，年龄中位数30岁）完成，涵盖了广泛的体育学科和比赛水平。根据“运动依赖性量表21”，有6％被归类为运动成瘾。绝大多数运动成瘾和非运动成瘾的运动员都同意，PPE应该是强制性的（92％和96％，P = 0.17），合格决定权应留给运动医学医师（82％和89％，P = 0.08） 。如果发现了心血管疾病，如果运动成瘾的运动员允许恢复进行高强度运动，则更高比例的运动员将接受“心脏直视”手术（54％vs 31％，P<0.001），并在诊断出有猝死危险的疾病时继续锻炼（57比32％，P <0.001）。

结论 

运动成瘾不会影响对PPE的总体正面评价，但如果做出心血管诊断，可能会影响对医疗处方的遵守。在为运动员提供新诊断出的心脏病方面的咨询服务时，应考虑运动成瘾。