Arrhythmias & electrophysiology

Association Between Neighborhood Opportunity With Exercise-Related Cardiac Symptoms and ECG Abnormalities in US Youth Athletes

Circ Popul Health OutcomesPublished retrospectively analyzed the HeartBytes National Youth Cardiac Registry

Main finding · Exercise-related chest painResult — go to the resultAdjusted odds ratio 0.45 95% CI 0.32–0.63

Authors' conclusion

Youth athletes from lower-opportunity neighborhoods were underrepresented in preparticipation screening and demonstrated higher prevalence and adjusted odds of exercise-related cardiac symptoms and ECG abnormalities. Prospective longitudinal studies are needed to determine clinical significance and inform equitable screening strategies.

Study context

Population
Youth athletes aged <17 years attending community-based preparticipation screening events (physical exam and 12-lead ECG) across the United States between April 2015 and May 2024youth athletes (median age, 14 years, 38.9% female, 83.0% White)
Participants
7,843 athletes
Exposure
associations between child opportunity index quintile and exercise-related cardiac symptoms and ECG abnormalities
Methodological detailscommunity-based preparticipation screening events, multivariable logistic regression
  • Community-based preparticipation screening events
  • Multivariable logistic regression

Main finding

Exercise-related chest pain

Adjusted odds ratio

0.45

95% CI 0.32–0.63

By group

Very high vs very low
adjusted odds ratio 0.45 (95% CI 0.32–0.63)

As reported in the abstract

Observational data: associations, not effects.

Further findings

OutcomeValuesAdjusted odds ratio (95% CI)
Exercise-related fatigue · lower odds with very high quintile · multivariable adjustmentvery low prevalence 11.4% · very high prevalence 7.0%0.65 (0.47–0.87)
Abnormal ECGs · lower odds with very high quintile · multivariable adjustmentvery low prevalence 10.0% · very high prevalence 5.1%0.58 (0.42–0.82)
  • Exercise-related fatigue: unadjusted prevalence comparison: all P <0.001
  • Abnormal ECGs: unadjusted prevalence comparison: all P <0.001

Original publication

Association Between Neighborhood Opportunity With Exercise-Related Cardiac Symptoms and ECG Abnormalities in US Youth Athletes. Circ Popul Health Outcomes. Published 2 July 2026. doi:10.1161/circoutcomes.125.013065

Summarised from the published abstract; every number is checked against it

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