Section 1: A Need for Data-Driven Sports Participation Guidelines

Relying on Expert Consensus

Guidelines for sports participation among young competitive athletes with cardiovascular conditions have traditionally been based on expert consensus rather than prospective outcomes data. While this approach has provided general recommendations, it lacks the robust evidence needed to inform precise decision-making. Recognizing this gap, recent guidelines have embraced a shared decision-making model, emphasizing individualized assessments. However, the impact and outcomes of this approach require further investigation.

Introducing the ORCCA Study

The ORCCA (Outcomes Registry for Cardiac Conditions in Athletes) study is a groundbreaking prospective, multicenter, longitudinal, and observational cohort study designed to address the need for data-driven insights into cardiovascular risk in young competitive athletes. By monitoring clinical outcomes, exercise habits, psychosocial well-being, and decision-making processes, the study aims to generate an evidence base to inform future sports participation guidelines.

Section 2: Investigating Cardiovascular Outcomes and Decision-Making

Understanding the Study Design

The ORCCA study focuses on competitive athletes aged 18 to <35 years who have been diagnosed with a confirmed cardiovascular condition or have borderline findings with potential increased risk of major adverse cardiovascular events (MACE). The study’s initial follow-up period is set for five years or until age 35, during which the athletes’ clinical outcomes and psychosocial well-being will be monitored. The study aims to compare outcomes between athletes who continue participating in competitive sports and those who discontinue.

Primary and Secondary Outcomes

The primary outcome of the ORCCA study is the prevalence of adverse cardiovascular events in young competitive athletes with high-risk cardiovascular conditions or borderline findings. Adverse cardiovascular events include major adverse cardiovascular events (MACE) or disease-specific therapeutic interventions. The study will also examine secondary outcomes, such as the shared decision-making process leading to eligibility decisions, exercise habits, psychosocial factors, quality of life, and the effect of a cardiovascular diagnosis on emergency action plans and all-cause mortality.

Section 3: Implications and Future Directions

Informing Sports Participation Guidelines

By providing prospective outcomes data, the ORCCA study aims to enhance our understanding of the natural history, risk factors, and management of young competitive athletes with cardiovascular conditions. The study’s findings will be instrumental in shaping future sports participation guidelines, moving away from expert opinion towards evidence-based recommendations. The data will support more informed and individualized decision-making, ensuring the safety and well-being of young athletes.

Expanding the Scope

The ORCCA study has ambitious plans for future phases, including international expansion, the establishment of cardiac core interpretation laboratories for imaging and electrocardiographic data, the inclusion of athlete control populations, and the development of psychosocial and mental health interventions. These expansions will enable comparative analyses, accuracy assessments, and the implementation of targeted interventions to support athletes with cardiac diagnoses.

Section 4: Advancing Knowledge and Enhancing Athlete Well-Being

Filling a Critical Gap

The ORCCA study addresses the critical need for cardiovascular outcomes data in athletes with suspected or high-risk cardiovascular conditions. By shifting the focus from expert opinion to rigorous research, this study will provide much-needed evidence to guide clinical decision-making and improve the understanding of cardiovascular health in young competitive athletes.

A Landmark Endeavor

As the largest and most comprehensive prospective study of young competitive athletes with confirmed or suspected high-risk cardiac conditions, the ORCCA study holds tremendous potential to shape the field of sports cardiology. Through its thorough investigation of cardiovascular outcomes, decision-making processes, exercise habits, and psychosocial impacts, this study will shed light on the complexities of managing cardiac conditions in the context of competitive sports.