CRY’s Research

CRY has contributed to the following papers, reports, abstracts and conference proceedings. All these articles have been authored (or co-authored) by cardiologists, doctors and research fellows working closely with CRY.

Where possible, a link has been provided to the abstract and / or full text of the article. Where no link is available, you may be able to get hold of the article via your nearest public / university library. References are listed by year of publication.

Professor Sanjay Sharma - CRY Consultant Cardiologist

Professor Sanjay Sharma

I have been involved with CRY since 1996 and they have facilitated several research projects relating to regional/national British athletes. Most of the work was generated from cardiovascular evaluation of athletes as part of a screening programme aimed to identify disorders capable of causing sudden cardiac death. We evaluated several thousand athletes aged 14-35 years and had many "firsts" in the scientific literature.

  • CRY were the first to provide information on the physiological upper limits of cardiac dimensions in adult National British athletes (Published in European Journal of Applied Physiology).
  • CRY were the first organisation ever to characterise cardiac dimensions in a large cohort of adolescent athletes, who are most vulnerable to sudden death during sport from cardiomyopathy. Landmark studies in the Journal of American College of Cardiology and Heart are the main international studies on this subject.
  • CRY wrote the first paper on ECG changes in adolescent athletes (1000 athletes studied) which was published in the British Journal of Sports Medicine and is a blueprint for the European Society of Sports Cardiology.
  • CRY have performed the only study on cardiovascular adaptation in athletes of West African origin. The results show that ECGs in black athletes are quite different to those in white athletes and could be mistaken for serious cardiac disorder.
  • CRY are the first organisation to state the prevalence and significance of an isolated long QT interval in elite athletes. This study has called for revision of consensus guidelines published by the American College of Cardiology.
  • CRY is the first to describe the prevalence of HCM in elite athletes.

The International Olympic Committee (IOC) Consensus Statement on Periodic Health Evaluation of Elite Athletes

March 2009

The scope of the cardiovascular PHE is to detect potentially lethal cardiovascular disease in elite athletes and start appropriate management to reduce the risk for sudden cardiac death and/or disease progression in a timely fashion.

Research news from the CRY Research Highlights magazine

 

CRY's Papers and Publications

Research into sudden cardiac death in adolescent footballers Q&A with Dr Aneil Malhotra

How did you conduct your study? This study sought to investigate the incidence and causes of sudden cardiac death in adolescent football players in the UK. The English Football Association cardiac screening programme enabled us to study a well-defined population of over 11,000 scholar footballers in a systematic way. The study itself was conducted across […]


Sudden Cardiac Death In Elite Footballers Higher Than Anticipated

• One in 50 players had a heart abnormality that needed ongoing monitoring • Almost three quarters of footballers diagnosed were able to return to play • The FA continues to provide vital insight into screening policy in sport and has invested more than £3.1 million into its screening programme After a heroic effort in […]


The relationship between left ventricular structure and function in the elite rugby football league athlete as determined by conventional echocardiography and myocardial strain imaging

Forsythe L, MacIver DH, Johnson C, George K, Somauroo J, Papadakis M, Brown B, Qasem M, Oxborough D The relationship between left ventricular structure and function in the elite rugby football league athlete as determined by conventional echocardiography and myocardial strain imaging International Journal of Cardiology, June 2018 {Abstract}


British Cardiovascular Society Conference 2018 – Dr Steven Cox

Once again the team of Cardiac Risk in the Young doctors led by Professor Sanjay Sharma have had a massive impact at the British Cardiac Society conference this week. Some of the highlights included presentations from Prof Sharma, Dr Michael Papadakis, Dr Elijah Behr, Dr Sabiha Gati and Dr Aneil Malhotra. But the real highlight […]


Ajmaline test Q&A with Dr Michael Papadakis

Dr Michael Papadakis answers some of your questions about their recent research publication identifying the importance of routine ajmaline testing after a SADS death. Q. When families are referred after a sads death to the CRY Centre for Inherited Cardiac Conditions at St George’s Hospital would they always/usually have the ajmaline test on the same […]


A guideline update for the practice of echocardiography in the cardiac screening of sports participants: a joint policy statement from the British Society of Echocardiography and Cardiac Risk in the Young

David Oxborough, Daniel Augustine, Sabiha Gati, Keith George, Allan Harkness, Thomas Mathew, Michael Papadakis, Liam Ring, Shaun Robinson, Julie Sandoval, Rizwan Sarwar, Sanjay Sharma, Vishal Sharma, Nabeel Sheikh, John Somauroo, Martin Stout, James Willis, and Abbas Zaidi. A guideline update for the practice of echocardiography in the cardiac screening of sports participants: a joint policy statement from the British […]


The Diagnostic Yield of Brugada Syndrome After Sudden Death With Normal Autopsy

Michael Papadakis, Efstathios Papatheodorou, Greg Mellor, Hariharan Raju, Rachel Bastiaenen, Yanushi Wijeyeratne, Sara Wasim, Bode Ensam, Gherardo Finocchiaro, Belinda Gray, Aneil Malhotra, Andrew D’Silva, Nina Edwards, Della Cole, Virginia Attard, Velislav N. Batchvarov, Maria Tome-Esteban, Tessa Homfray, Mary N. Sheppard, Sanjay Sharma and Elijah R. Behr The Diagnostic Yield of Brugada Syndrome After Sudden Death […]


Response by Merghani et al to Letters Regarding Article, ‘Prevalence of Subclinical Coronary Artery Disease in Masters Endurance Athletes With a Low Atherosclerotic Risk Profile.’

Ahmed Merghani, Viviana Maestrini, Stefania Rosmini, Andrew T. Cox, Harshil Dhutia, Rachel Bastiaenan, Sarojini David, Tee Joo Yeo, Rajay Narain, Aneil Malhotra, Michael Papadakis, Mathew G. Wilson, Maite Tome, Khaled AlFakih, James C. Moon, Sanjay Sharma Response by Merghani et al to Letters Regarding Article, ‘Prevalence of Subclinical Coronary Artery Disease in Masters Endurance Athletes […]


Inter-Rater Reliability and Downstream Financial Implications of Electrocardiography Screening in Young Athletes

Background—Preparticipation screening for cardiovascular disease in young athletes with electrocardiography is endorsed by the European Society of Cardiology and several major sporting organizations. One of the concerns of the ECG as a screening test in young athletes relates to the potential for variation in interpretation. We investigated the degree of variation in ECG interpretation in […]


Pre-participation Cardiovascular Evaluation for Athletic Participants to Prevent Sudden Death: Position Paper from the EHRA and the EACPR, Branches of the ESC. Endorsed by APHRS, HRS, and SOLAECE

Lluís Mont, Antonio Pelliccia, Sanjay Sharma Alessandro Biffi, Mats Borjesson, Josep Brugada Terradellas, Francois Carré, Eduard Guasch, Hein Heidbuchel, André La Gerche, Rachel Lampert, William McKenna, Michael Papadakis, Silvia G Priori, Mauricio Scanavacca, Paul Thompson, Christian Sticherling, Sami Viskin, Mathew Wilson, Domenico Corrado, Reviewers, Gregory YH Lip, Bulent Gorenek, Carina Blomström Lundqvist, Bela Merkely, Gerhard […]


Anterior T-Wave Inversion in Young White Athletes and Nonathletes: Prevalence and Significance

Aneil Malhotra, Harshil Dhutia, Sabiha Gati, Tee-Joo Yeo, Helder Dores, Rachel Bastiaenen, Rajay Narain, Ahmed Merghani, Gherardo Finocchiaro, Nabeel Sheikh, Alexandros Steriotis, Abbas Zaidi, Lynne Millar, Elijah Behr, Maite Tome, Michael Papadakis and Sanjay Sharma Anterior T-Wave Inversion in Young White Athletes and Nonathletes: Prevalence and Significance Journal of the American College of Cardiology, January […]


Costs should not stand in way of screening for hidden heart conditions

New research confirms screening IS cost effective and should be made available to ALL teens and young adults The Government has “got it wrong” when it comes to listening to the recommendations of its National Screening Committee regarding the implementation of a UK cardiac screening programme for your young people. That’s the verdict of the […]


Whole exome sequence analysis reveals a homozygous mutation in PNPLA2 as the cause of severe dilated cardiomyopathy secondary to neutral lipid storage disease

M. Muggenthaler, E. Petropoulou, S. Omer, M.A. Simpson, H. Sahak, A. Rice, H. Raju, F.J. Conti, L.R. Bridges, L.J. Anderson, S. Sharma, E.R. Behr, Y. Jamshidi Whole exome sequence analysis reveals a homozygous mutation in PNPLA2 as the cause of severe dilated cardiomyopathy secondary to neutral lipid storage disease International Journal of Cardiology, May 2016 […]


Etiology of Sudden Death in Sports

Gherardo Finocchiaro, MD; Michael Papadakis, MBBS, MD; Jan-Lukas Robertus, MD; Harshil Dhutia, MBBS; Alexandros Klavdios Steriotis, MD, PhD; Maite Tome, MD, PhD; Greg Mellor, MBChB; Ahmed Merghani, MBBS; Aneil Malhotra, MBBChir; Elijah Behr, MBBS, MD; Sanjay Sharma, MBChB, MD; Mary N. Sheppard, MBBCh, BAO, MD Etiology of Sudden Death in Sports Insights from a United […]


CRY Research Fellow’s paper receives praise from leading cardiologist

CRY research continues to underline the importance of cardiac screening for athletes After a successful three days at the BCS Annual Conference (June 6 – 8 2016), where the team from Cardiac Risk in the Young (CRY) really was at the “heart” of the debate about the benefits of proactive cardiac screening, – CRY is also […]


Exercise and Inherited Arrhythmias

Christopher C. Cheung, MD, Zachary W.M. Laksman, MD, FRCPC, MSc, Gregory Mellor, MA, MB BChir MRCP, Shubhayan Sanatani, MD, FRCPC, Andrew D. Krahn, MD, Exercise and Inherited Arrhythmias Canadian Journal of Cardiology, April 2016 {Abstract}


Calls for wider cardiac screening as new research confirms it's not just athletes and “sporty” young people at risk

Published papers conclude that sudden arrhythmic death (SADS) is more common ‘at rest’ or whilst sleeping than during excessive exercise Researchers funded by the charity, Cardiac Risk in the Young (CRY) have today [16 December 2014] published new research in the journal, “Circulation: Arrhythmia & Electrophysiology”1 highlighting that more than 80% of cases of young […]


CRY Parliamentary Reception 2014

The Terrace Marquee, Westminster – 26th November. Guest of Honour: Lee Mears, former England rugby union international.             CRY’s 2014 Parliamentary Reception on Wednesday November 26 was an event packed not only with CRY Representatives, supporters, bereaved families, members of the myheart group and doctors, but also several CRY Patrons […]


CRY Research Fellow Dr Sabiha Gati wins award at EuroPRevent 2013

18th – 20th April 2013 We are delighted to report that CRY Research Fellow Dr Sabiha Gati won the Judges’ Choice award at the EuroPRevent 2013 conference in Rome, for her poster “The Prevalence and Significance of Aortic Root Dilatation in Highly Trained British Athletes”.  


Should axis deviation or atrial enlargement be categorised as abnormal in young athletes? The athlete's electrocardiogram: time for re-appraisal of markers of pathology

Gati, S., Sheikh, N., Ghani, S., Zaidi, A., Wilson, M., Raju, H., Cox, A., Reed, M., Papadakis M. and Sharma, S.“Should axis deviation or atrial enlargement be categorised as abnormal in young athletes? The athlete’s electrocardiogram: time for re-appraisal of markers of pathology.”European Heart Journal 20th September 2013  [Abstract]


Clinical significance of electrocardiographic right ventricular hypertrophy in athletes: comparison with arrhythmogenic right ventricular cardiomyopathy and pulmonary hypertension

Zaidi, A., Ghani, S., Sheikh, N., Gati, S., Bastiaenen, R., Madden, B., Papadakis, M., Raju, H., Reed, M., Sharma, R., Behr, E.R., and Sharma, S.“Clinical significance of electrocardiographic right ventricular hypertrophy in athletes: comparison with arrhythmogenic right ventricular cardiomyopathy and pulmonary hypertension.”European Heart Journal 17th September 2013  [Abstract]


The Echocardiographic Assessment of the Right Ventricle with particular reference to Arrhythmogenic Right Ventricular Cardiomyopathy – A Protocol of the British Society of Echocardiography

Oxborough, D., Zaidi, A., Sharma, S. and Somauroo, J. “The Echocardiographic Assessment of the Right Ventricle with particular reference to Arrhythmogenic Right Ventricular Cardiomyopathy – A Protocol of the British Society of Echocardiography.” ECHO – Journal of the British Society of Echocardiography May 2013, p12-18


A Guideline for the Practice of Echocardiography in the Cardiovascular Screening of Sports Participants: A Joint Policy Statement of the British Society of Echocardiography and Cardiac Risk in the Young

Oxborough, D., Zaidi, A., Gati, S., Papadakis, M., Sheikh, N. and Sharma, S. “A Guideline for the Practice of Echocardiography in the Cardiovascular Screening of Sports Participants: A Joint Policy Statement of the British Society of Echocardiography and Cardiac Risk in the Young”.British Society of Echocardiography May 2013


New research highlights risk of 'false positives' among black athletes following cardiac testing

Published paper is ‘Editor’s Pick’ in April 30th issue of Circulation; and underlines the need for expert screening and diagnosis to prevent unnecessary disqualification of elite athletes. Researchers funded by CRY have published new research in one of the world’s leading cardiology journals, ‘Circulation’, which highlights the importance of expertise when conducting cardiac screening, because […]


Increased left ventricular trabeculation in highly trained athletes: do we need more stringent criteria for the diagnosis of left ventricular non-compaction in athletes?

Gati, S., Chandra, N., Bennett, R.L., Reed, M., Kervio, G., Panoulas, V.F., Ghani, S., Sheikh, N., Zaidi, A., Wilson, M., Papadakis, M., Carre, F. and Sharma, S. “Increased left ventricular trabeculation in highly trained athletes: do we need more stringent criteria for the diagnosis of left ventricular non-compaction in athletes?” Heart February 2013 [Abstract]


Support for inclusion of electrocardiography in addition to the Health Questionnaire and Physical Examination in athletic screening protocols for diagnosis of unsuspected hypertrophic cardiomyopathy

Sheikh, N., Cox, A. and Sharma, S. “Support for inclusion of electrocardiography in addition to the Health Questionnaire and Physical Examination in athletic screening protocols for diagnosis of unsuspected hypertrophic cardiomyopathy.” The American Journal of Cardiology January 2013  [Full Text]


Significance of deep T-wave inversions in asymptomatic athletes with normal cardiovascular examinations: practical solutions for managing the diagnostic conundrum

Wilson, M.G., Sharma, S., Carré, F., Charron, P., Richard, P., O’Hanlon, R., Prasad, S.K., Heidbuchel, H., Brugada, J., Salah, O., Sheppard, M., George, K.P., Whyte, G., Hamilton, B. and Chalabi, H. “Significance of deep T-wave inversions in asymptomatic athletes with normal cardiovascular examinations: practical solutions for managing the diagnostic conundrum.” British Journal of Sports Medicine November […]


CRY Research Fellow Dr Saqib Ghani wins award at EuroPRevent 2012

We are delighted to report that CRY Research Fellow Dr Saqib Ghani won the Judges’ Choice award at the EuroPRevent 2012 conference, for his abstract “Cardiovascular abnormalities in potential British olympic squad: impact of IOC recommendations for cardiovascular evaluation prior to 2012 olympics”.


Role of Automated External Defibrillators (AED) in Sports

Ghani, S. and Sharma, S. “Role of Automated External Defibrillators (AED) in Sports.” Book chapter in Cardiac Defibrillation – Mechanisms, Challenges and Implications, Edited by Trayanova, N. Published by InTech, September 2011 [Full Text]


Chest pain – troponin and athletes

Dr Abbas Zaidi, CRY Research Fellow, highlights the importance of expertise in Sports Cardiology in a debate in the British Journal of Cardiology: “Chest pain – troponin and athletes” http://bjcardio.co.uk/2011/08/correspondence-5/ (second letter) British Journal of Cardiology August 2011 Vol.18, Issue 4, p179 [This is in response to http://bjcardio.co.uk/2011/06/correspondence-4/]


The athlete's heart

Zaidi, A. and Sharma, S. “The athlete’s heart” British Journal of Hospital Medicine May 2011 Vol.27, No.5, p275-281 [Abstract]


Inherited cardiomyopathies

Raju, H., Alberg, C., Sagoo, G.S., Burton, H. and Behr, E.R. “Inherited cardiomyopathies” British Medical Journal 2011  [Full Text]


Sudden cardiac death

Papadakis, M. and Sharma, S. “Sudden cardiac death.” Medicine 2010 Vol.38, p502-506  [Abstract]


Differentiation of RVOT-VT and ARVC in an elite athlete

Whyte, G.P., Stephens, N., Senior, R., Peters, N., O’Hanlon, R. and Sharma, S. “Differentiation of RVOT-VT and ARVC in an elite athlete.” Medicine & Science in Sports & Exercise 2008 Vol.40, No.8, p1357-1361 [Abstract]


Ethnic differences in left ventricular remodeling in highly-trained athletes relevance to differentiating physiologic left ventricular hypertrophy from hypertrophic cardiomyopathy

Basavarajaiah, S., Boraita, A., Whyte, G., Wilson, M., Carby, L., Shah, A. and Sharma, S. “Ethnic differences in left ventricular remodeling in highly-trained athletes relevance to differentiating physiologic left ventricular hypertrophy from hypertrophic cardiomyopathy.” Journal of the American College of Cardiology 2008 Vol.51, No.23, p2256-2262  [Abstract]


Physiological left ventricular hypertrophy or hypertrophic cardiomyopathy in an elite adolescent athlete: role of detraining in resolving the clinical dilemma

Basavarajaiah, S., Wilson, M., Junagde, S., Jackson, G., Whyte, G., Sharma, S. and Roberts, W.O. “Physiological left ventricular hypertrophy or hypertrophic cardiomyopathy in an elite adolescent athlete: role of detraining in resolving the clinical dilemma.” British Journal of Sports Medicine 2006 Vol.40, No.8, p727-729  [Abstract]


Spontaneous atrial fibrillation in a freestyle skier

Whyte, G., Stephens, N., Sharma, S., Shave, R.E., Budgett, R. and McKenna, W.J. “Spontaneous atrial fibrillation in a freestyle skier.” British Journal of Sports Medicine 2004 Vol.38, No.2, p230-232  [Abstract]  [Full Text]


Physiologic limits of left ventricular hypertrophy in elite junior athletes: relevance to differential diagnosis of athlete's heart from hypertrophic cardiomyopathy

Sharma, S., Maron, B.J., Whyte, G., Firoozi, S., Elliott, P.M. and McKenna, W.J. “Physiologic limits of left ventricular hypertrophy in elite junior athletes: relevance to differential diagnosis of athlete’s heart from hypertrophic cardiomyopathy.” Journal of the American College of Cardiology 2002 (October) Vol.40 Issue 8, p1431-1436  [Abstract]


Sudden death in young athletes: HCM or ARVC?

Firoozi, S, Sharma, S., Hamid, M.S. and McKenna, W.J. “Sudden death in young athletes: HCM or ARVC?” Cardiovascular Drugs and Therapy 2002 (January) Vol.16 No.1, p.11-17  [Abstract]


Sudden death in young athletes

McKenna, W.J., Firoozi,S. and Sharma, S. “Sudden death in young athletes.” 11th European Meeting of the French Society of Cardiology 2001


Peak oxygen consumption measurement differentiates physiological left ventricular hypertrophy in junior athletes from pathological hypertrophy in adolescents with hypertrophic cardiomyopathy

Firoozi, S., Sharma, S., Mist, B., Elliott, P.M., Whyte, G. and McKenna, W.J. “Peak oxygen consumption measurement differentiates physiological left ventricular hypertrophy in junior athletes from pathological hypertrophy in adolescents with hypertrophic cardiomyopathy.” Heart 2001 Vol.85 (Supplement I), p.31


Utility of cardiopulmonary exercise in the assessment of clinical determinants of functional capacity and elucidation of potential mechanisms of exercise limitation in hypertrophic cardiomyopathy

Sharma S., Elliott P.M., Whyte, G., Jones, S., Mahon, N., Whipp, B. and McKenna W.J. “Utility of cardiopulmonary exercise in the assessment of clinical determinants of functional capacity and elucidation of potential mechanisms of exercise limitation in hypertrophic cardiomyopathy.” American Journal of Cardiology 2000 (July) Vol.86 No.2, p162-168 [Abstract]


Differentiation of physiological left ventricular hypertrophy in junior elite athletes from pathological hypertrophy in adolescents with hypertrophic cardiomyopathy using peak oxygen consumption measurement

Firoozi, S., Sharma, S., Mist, B., Elliott, P.M., Whyte, G. and McKenna, W.J. “Differentiation of physiological left ventricular hypertrophy in junior elite athletes from pathological hypertrophy in adolescents with hypertrophic cardiomyopathy using peak oxygen consumption measurement.” 4th European Workshop on Hypertrophic Obstructive Cardiomyopathy 2000


Cardiac Dimensions in Junior Athletes

Sharma, S., Whyte, G., Elliott, P. and McKenna, W.J. “Cardiac Dimensions in Junior Athletes.” Proceedings of the European College of Sports Science 1998


Arrhythmias and Sudden Death in Hypertrophic Cardiomyopathy. Epidemiology, Pathophysiology, Primary Prevention, Immediate Evaluation and Management, Long-Term Management, Experimental and Theoretical Developments

McKenna, W.J. and Sharma, S. “Arrhythmias and Sudden Death in Hypertrophic Cardiomyopathy. Epidemiology, Pathophysiology, Primary Prevention, Immediate Evaluation and Management, Long-Term Management, Experimental and Theoretical Developments.” Cardiac Electrophysiology Review 1997 (March) Vol.1 No’s.1-2, p229-232