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Marked ventricular repolarization abnormalities in highly trained athletes' electrocardiograms: clinical and
R Serra-Grima1, M Estorch, I Carrió
1Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Centre d'Estudis d'Alt Rendiment Esportiu, Barcelona, Spain. arodrigo@hsp.santpau.es
Journal of the American College of Cardiology
|October 12, 2000
Summary
Marked repolarization abnormalities (MRA) on athlete ECGs are not clinically significant. These findings do not impact physical training or sports participation.
Area of Science:
- Cardiology
- Sports Medicine
- Exercise Physiology
Background:
- The clinical significance of marked repolarization abnormalities (MRA) in athletes' electrocardiograms (ECGs) is not well understood.
- The relationship between training intensity, sport type, and MRA remains unclear.
- Athletes with MRA are typically asymptomatic with preserved physical performance, raising questions about potential negative impacts on competitive sports.
Purpose of the Study:
- To investigate the functional, clinical, and prognostic implications of marked repolarization abnormalities (MRA) in athletes.
- To determine if MRA affect athletic performance or indicate underlying cardiac pathology.
Main Methods:
- Studied 26 athletes with MRA (defined as negative T waves ≥2 mm in ≥3 leads at rest).
- Conducted clinical examinations, resting ECG, exercise tests, echocardiography, and antimyosin studies.
- Performed myocardial perfusion SPECT in 17 athletes; follow-up ranged from 4 to 20 years.
Main Results:
- Excluded 4 athletes with hypertrophic cardiomyopathy; remaining athletes had normal ventricular dimensions.
- Resting ECGs showed "pseudoischemia" that normalized during exercise; myocardial perfusion studies were normal.
- Antimyosin studies revealed mild myocardial radiotracer uptake in 68% of athletes; no adverse clinical events occurred during follow-up.
Conclusions:
- Marked repolarization abnormalities (MRA) in athletes appear to have no adverse clinical or pathological implications.
- MRA should not be a barrier to physical training or participation in competitive sports.