Does the Italian model reduce the number of sudden cardiac deaths in young athletes?
Although hypertrophic cardiomyopathy is the commonest cause of exercise related sudden cardiac death in the United States, in Italy it is responsible for a much smaller proportion of deaths. Although antagonists of preparticipation screening argue that this might reflect a lower genetic cluster of people with hypertrophic cardiomyopathy in the Mediterranean region, these figures probably reflect the efficacy of the Italian programme in identifying athletes with hypertrophic cardiomyopathy and minimising deaths through disqualification from sport; none of the 22 athletes identified with hypertrophic cardiomyopathy in the Veneto region between 1979 and 1996 died during a mean follow-up of 8.2 years. Of the 49 deaths recorded among young athletes during the same period, only one had hypertrophic cardiomyopathy (2%)—lower than the incidence of 7.3% recorded in 220 sudden deaths among non-athletes. 13 The most compelling evidence for the Italian preparticipation screening model reducing the
