{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T19:04:04Z","timestamp":1790708644710,"version":"4.1.0"},"reference-count":40,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Sports Med"],"accepted":{"date-parts":[[2025,11,26]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Studies to date have under-represented cardiac characteristics of para athletes, despite their unique cardiovascular physiology and risks. This study examined the cardiac electrical and structural characteristics and outcomes of pre-participation cardiac screening in elite para-football players.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between 2011 and 2024, 156 consecutive para-football players underwent pre-participation evaluation comprising a health questionnaire, 12-lead ECG and echocardiogram. Players with symptoms or abnormal preliminary investigations were evaluated further, including exercise testing and cardiac MRI. Findings were compared with 1000 consecutive sex-matched and ethnicity-matched non-para-football players. Mean follow-up was 4.7\u00b13.1 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The mean age of para-football players was 21.2\u00b15.2 years. The majority were male (71.2%) and white ethnicity (84%), followed by mixed-race (7.1%), Asian (4.5%) and Afro-Caribbean (3.8%) ethnicity. Para-football players reported cardiac symptoms more frequently and required more follow-up than non-para players (14.7% vs 6.6%; p=0.001). Para players demonstrated less sinus bradycardia (35.3% vs 44.5%; p=0.037) and a similar prevalence of abnormal T-wave inversion (1.9% vs 3.0%; p=0.622). A short PR interval was observed in 4.5% of para players compared with 0.5% of non-para players (p&lt;0.001), although QTc intervals were similar between the two groups (402\u00b124 ms vs 399\u00b119 ms; p=0.138). Four (2.6%) para-football players received diagnoses associated with sudden cardiac death (SCD) versus three (0.3%) non-para players (p=0.005). Six (3.8%) para-football players were diagnosed with minor cardiovascular conditions versus 1.8% non-para players (p=0.17). In total, 10 (6.4%) para-football players were diagnosed with cardiac pathology versus 21 (2.1%) non-para-football players (p=0.005), all of whom required management or were kept under surveillance. No SCD events occurred over 4.7\u00b13.1 years of follow-up in para-football players.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this study, para-football players were three times more likely to be diagnosed with a cardiac condition requiring management and\/or surveillance compared with non-para players. Moreover, para-football players had a higher prevalence of serious cardiac disease associated with SCD. Cardiac screening inclusive of ECG is warranted in this growing cohort of athletes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjsports-2025-110406","type":"journal-article","created":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T10:30:18Z","timestamp":1765535418000},"page":"240-247","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Outcomes of cardiac screening in elite para-football players in the United Kingdom"],"prefix":"10.1136","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4124-6421","authenticated-orcid":false,"given":"Kentaro","family":"Yamagata","sequence":"first","affiliation":[{"name":"Institute of Sport, Manchester Metropolitan University, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6216-839X","authenticated-orcid":false,"given":"Richard","family":"Weiler","sequence":"additional","affiliation":[{"name":"Institute of Sport, Exercise & Health, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3604-7957","authenticated-orcid":false,"given":"Raghav T","family":"Bhatia","sequence":"additional","affiliation":[{"name":"Hull University Teaching Hospitals NHS Trust, Hull, UK"},{"name":"St George\u2019s University of London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie S","family":"McPhee","sequence":"additional","affiliation":[{"name":"Institute of Sport, Manchester Metropolitan University, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte M","family":"Cowie","sequence":"additional","affiliation":[{"name":"The Football Association, St. George's Park, Burton upon Trent, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3630-6138","authenticated-orcid":false,"given":"Sanjay","family":"Sharma","sequence":"additional","affiliation":[{"name":"St George\u2019s University of London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aneil","family":"Malhotra","sequence":"additional","affiliation":[{"name":"Institute of Sport, Manchester Metropolitan University, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,12,12]]},"reference":[{"key":"2026021205200626000_60.4.240.1","first-page":"e1385","article-title":"Noncommunicable disease among adults with cerebral palsy: A matched cohort study","volume":"93","author":"Ryan","year":"2019","journal-title":"Neurology (ECronicon)"},{"key":"2026021205200626000_60.4.240.2","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.3390\/healthcare11071027","article-title":"The Prevalence of Cardiovascular Diseases in Paralympic Athletes","volume":"11","author":"Sawczuk","year":"2023","journal-title":"Healthcare (Basel)"},{"key":"2026021205200626000_60.4.240.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0079-6123(05)52014-4"},{"key":"2026021205200626000_60.4.240.4","first-page":"150","article-title":"Sports Cardiology and the Paralympic Athlete","volume":"7","author":"Toresdahl","year":"2019","journal-title":"Aspetar Sports Medicine Journal"},{"key":"2026021205200626000_60.4.240.5","unstructured":"The Football Association (FA) . 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