Introduction

The etiology of sudden cardiac death (SCD) in young people continues to attract much attention. This meta-analysis aimed to identify the most frequent causes of SCD in individuals aged ≤35 years, the differences between athletes and non-athletes and geographic areas.

Methods

Studies published between 01/01/1990 and 01/31/2020 and evaluating post-mortem the aetiology of SCD in young individuals (≤35 years) were included. Individuals were divided into athletes and non-athletes. Studies that did not report separate data between athletes and non-athletes were excluded.

Results

Thirty-four studies met the inclusion criteria, and a total population of 5,060 victims of SCD were analyzed (2,890 athletes, 2,170 non-athletes). Comparing the causes of SCD between athletes and non-athletes, non-ischemic left ventricular scar (NILVS) (5.1% vs. 1.1%, p=0.01) was more frequent in the former, while coronary artery disease (CAD) (19.6% vs. 9.1%, p=0.009), arrhythmogenic cardiomyopathy (ACM) (11.5% vs. 4.7%, p=0.03) and channelopathies (8.4% vs. 1.9%, p=0.02) were more frequent in the latter. In studies published in the last decade, hypertrophic cardiomyopathy (HCM) (p=0.002), dilated cardiomyopathy (p=0.047), and anomalous origin of coronary arteries (AOCA) (p=0.009) were more frequently the causes of SCD in athletes while aortic dissection (0.022) was the cause in non-athletes. HCM (p=0.01) and AOCA (p=0.004) were more frequently the causes of SCD in the US while ACM (p=0.001), structurally normal heart (p=0.02), and channelopathies (p=0.02) were more frequent in Europe.

Conclusions

Among the causes of SCD, NILVS was the more frequent cause in athletes, while CAD, ACM and channelopathies were more frequent causes in non-athletes. The causes of SCD differ between the US and Europe.

中文翻译：

---

年轻运动员和非运动员心源性猝死的原因：系统评价和荟萃分析

介绍

年轻人心源性猝死 (SCD) 的病因一直备受关注。这项荟萃分析旨在确定 35 岁以下个体中 SCD 的最常见原因、运动员和非运动员之间的差异以及地理区域。

方法

纳入了 1990 年 1 月 1 日至 2020 年 1 月 31 日之间发表的研究，并在死后评估了年轻个体（≤35 岁）中 SCD 的病因。个人分为运动员和非运动员。未报告运动员和非运动员之间单独数据的研究被排除在外。

结果

34 项研究符合纳入标准，共分析了 5,060 名 SCD 患者（2,890 名运动员，2,170 名非运动员）。比较运动员和非运动员之间 SCD 的原因，非缺血性左心室瘢痕 (NILVS) (5.1% vs. 1.1%, p=0.01) 在前者更常见，而冠状动脉疾病 (CAD) (19.6%)与 9.1%, p=0.009)、致心律失常性心肌病 (ACM) (11.5% vs. 4.7%, p=0.03) 和离子通道病 (8.4% vs. 1.9%, p=0.02) 在后者中更常见。在过去十年发表的研究中，肥厚型心肌病 (HCM) (p=0.002)、扩张型心肌病 (p=0.047) 和冠状动脉异常起源 (AOCA) (p=0.009) 是运动员 SCD 的常见原因而主动脉夹层（0.022）是非运动员的原因。HCM (p=0.01) 和 AOCA (p=0.

结论

在 SCD 的原因中，NILVS 是运动员中更常见的原因，而非运动员中 CAD、ACM 和离子通道病是更常见的原因。美国和欧洲的 SCD 病因不同。