Skip to main content

Practical Use of Genetic Testing in Athletes

  • Chapter
  • First Online:
Sports Cardiology

Abstract

Genetic testing for health-related purposes is becoming increasingly common in the practice of medicine. Identification of genetic forms of cardiovascular disease, including channelopathies, cardiomyopathies, and aortopathies, is becoming more of an important component of sports cardiology practices. This chapter will review general principles of genetic testing and provide guidance on how genetic testing can help in the detection of inherited cardiovascular disorders that are associated with sudden cardiac death and which have an impact on athletes and decisions regarding sports participation. Medical providers who are provided with genetic data on their patient-athletes must be able to separate properly used and validated genetic information from increasingly popular direct-to-consumer genetic testing products that offer unsupported claims to predict such things as athletic ability, sports performance, and injury risk. The growing market of such genetic tests being advertised directly to the athletic community has led to a 2015 scientific consensus statement warning on the danger of these products to aspiring athletes that can be detrimental to their physical and psychological health. Our role as healthcare providers is to use validated genetic testing practices and data as an added tool promoting the health and safety of athletes.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Brugada R, Campuzano O, Sarquella-Brugada G, et al. Brugada syndrome. 2005 Mar 31 [Updated 2016 Nov 17]. In: Adam MP, Ardinger HH, Pagon RA, et al., editors. GeneReviews [Internet]. Seattle (WA): University of Washington; 1993–2019. Available from: https://www.ncbi.nih.gov/books/NBK1517.

  2. Richards S, Aziz N, Bale S, Laboratory Quality Assurance Committee, et al. Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association of Molecular Pathology. Genet Med. 2015;17(5):405–24.

    Article  Google Scholar 

  3. Green RC, Berg JS, Grody WW, et al. ACMG Recommendations for reporting of incidental findings in clinical exome and genome sequencing. Genet Med. 2013;15(7):565–74.

    Article  CAS  Google Scholar 

  4. Cooper DN, Krawczak M, Polychronakos C, Tyler-Smith C, Kehrer-Sawatzk H. Where genotype is not predictive of phenotype: towards an understanding of the molecular basis of reduced penetrance in human inherited disease. Hum Genet. 2013;132(10):1077–130.

    Article  CAS  Google Scholar 

  5. Maron BJ. The paradox of exercise. N Engl J Med. 2000;343:1409–11.

    Article  CAS  Google Scholar 

  6. Wasfy MM, Hutter AM, Weiner RB. Sudden cardiac death in athletes. Methodist Debakey Cardiovasc J. 2016;12(2):76–80.

    Article  Google Scholar 

  7. Harmon KG, Asif IM, Maleszewski JJ, et al. Incidence, cause, and comparative frequency of sudden cardiac death in National Collegiate Athletic Association Athletes: a decade in review. Circulation. 2015;132(1):10–9.

    Article  Google Scholar 

  8. Roberts WO, Stovitz SD. Incidence of sudden cardiac death in Minnesota high school athletes 1993–2012 screened with a standardized pre-participation evaluation. J Am Coll Cardiol. 2013;62:1298–301.

    Article  Google Scholar 

  9. Steinvil A, Chundadze T, Zeltser D, et al. Mandatory electrocardiographic screening of athletes to reduce their risk for sudden death proven fact or wishful thinking? J Am Coll Cardiol. 2011;57:1291–6.

    Article  Google Scholar 

  10. Tiziano FD, Palmieri V, Genuardi M, Zeppilli P. The role of genetic testing in the identification of young athletes with inherited primitive cardiac disorders at risk of exercise sudden death. Front Cardiovasc Med. 2016;3:28.

    Article  Google Scholar 

  11. Maron BJ, Udelson JE, Bonow RO, et al. Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: task force 3. Circulation. 2015;132:e273–80.

    PubMed  Google Scholar 

  12. Pelliccia A, Zipes DP, Maron BJ. Bethesda Conference #36 and the European Society of Cardiology Consensus Recommendations revisited a comparison of U.S. and European criteria for eligibility and disqualification of competitive athletes with cardiovascular abnormalities. J Am Coll Cardiol. 2008;52(24):1990–6.

    Article  Google Scholar 

  13. Pellicia A, Solberg EE, Papadakis M, et al. Recommendations for participation in competitive and leisure time sport in athletes with cardiomyopathies, myocarditis, and pericarditis: position statement of the Sport Cardiology Section of the European Association of Preventive Cardiology (EAPC). Eur Heart J. 2019;40:19–33.

    Article  Google Scholar 

  14. Towbin JA, McKenna WJ, Abrams DJ, et al. 2019 HRS expert consensus statement on evaluation, risk stratification, and management of arrhythmogenic cardiomyopathy. Heart Rhythm. 2019;16(11):e373–407.

    Article  Google Scholar 

  15. Marcus FI, Mckenna WJ, Sherrill D, et al. Diagnosis of arrhythmogenic right ventricular cardiomyopathy / dysplasia proposed modification of the task force criteria. Circulation. 2010;121:1533–41.

    Article  Google Scholar 

  16. Lieve KV, van der Werf C, Wilde AA. Wilde catecholaminergic polymorphic ventricular tachycardia. Circ J. 2016;80(6):1285–91.

    Article  Google Scholar 

  17. Panhuyzen-Goedkoop NM, Wilde AAM. Athletes with channelopathy may be eligible to play. Neth Heart J. 2018;26(3):146–53.

    Article  CAS  Google Scholar 

  18. Yang N, MacArthur DG, Gulbin JP, et al. ACTN3 Genotype is associated with human elite athletic performance. Am J Hum Genet. 2003;73(3):627–31.

    Article  CAS  Google Scholar 

  19. Terrell TR, Bostick RM, Abramson R, et al. Apoe, Apoe promoter and Tau genotypes and risk for concussion in college athletes. Clin J Sport Med. 2008;18(1):10–7.

    Article  Google Scholar 

  20. Ma F, Yang Y, Li X, et al. The association of sport performance with ACE and ACTN3 genetic polymorphisms: a systematic review and meta-analysis. PLoS One. 2013;8(1):e54685.

    Article  CAS  Google Scholar 

  21. Wagner JK. Playing with heart and soul…and genomes: sports implications and applications of personal genomics. PeerJ. 2013;1:e120.

    Article  Google Scholar 

  22. Mattsson CM, Wheeler MT, Waggott D, Caleshu C, Ashley EA. Sports genetics moving forward: lessons learned from medical research. Physiol Genomics. 2016;48(3):175–82.

    Article  CAS  Google Scholar 

  23. Webborn N, Williams A, McNamee M, et al. Direct-to-consumer genetic testing for predicting sports performance and talent identification: consensus statement. Br J Sports Med. 2015;49(23):1486–91.

    Article  Google Scholar 

  24. The world antidoping code: international standard 2018. https://www.wada-ama.org/.

  25. Beck H. Curry faces tests to evaluate risk factor. The New York Times. 5 Oct 2005.

    Google Scholar 

  26. The Genetic Information Nondiscrimination Act of 2008. https://www.eeoc.gov/laws/statutes/gina.cfm.

  27. Magavern EF, Badalato L, Finocchiaro G, Borry P. Ethical considerations for genetic testing in the context of mandated cardiac screening before athletic participation. Genet Med. 2017;19(5):493–5.

    Article  Google Scholar 

  28. Maron BJ, Friedman R, Caplan A. Ethics of preparticipation cardiovascular screening for athletes. Nat Rev Cardiol. 2015;12:1–4.

    Article  Google Scholar 

  29. Direct-to-Consumer genetic tests: misleading test results are further complicated by deceptive marketing and other questionable practices: congressional testimony. US Government Accountability Office. 22 July 2010. https://www.gao.gov/products/GAO-10-847.

  30. Vlahovich N, Fricker PA, Brown MA, Hughes D. Ethics of genetic testing and research in sport: a position statement from the Australian Institute of Sport. Br J Sports Med. 2017;51:5–11.

    Article  Google Scholar 

  31. Monteforte N, Napolitano C, Priori SG. Genetics and arrhythmias: diagnostic and prognostic applications. Rev Esp Cardiol. 2012;65(3):278–86.

    Article  Google Scholar 

  32. Kalia SS, Adelman K, Bale SJ, et al. Recommendations for reporting of secondary findings in clinical exome and genome sequencing, 2016 update (ACMG SF v2.0): a policy statement of the American College of Medical Genetics and Genomics. Genet Med. 2017;19:249–55.

    Article  Google Scholar 

  33. Girolami F, Frisso G, Benelli M, et al. Contemporary genetic testing in inherited cardiac disease: tools, ethical issues, and clinical applications. J Cardiovasc Med. 2018;19:1–11.

    Article  Google Scholar 

  34. Goodlin GT, Roos TR, Roos AK, Kim SK. The dawning age of genetic testing for sports injuries. Clin J Sport Med. 2015;25(1):1–5.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Marc P. Waase .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Kalia, I., Latif, F., Reilly, M.P., Waase, M.P. (2021). Practical Use of Genetic Testing in Athletes. In: Engel, D.J., Phelan, D.M. (eds) Sports Cardiology. Springer, Cham. https://doi.org/10.1007/978-3-030-69384-8_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-69384-8_4

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-69383-1

  • Online ISBN: 978-3-030-69384-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics