Early repolarization in middle-age runners: cardiovascular characteristics

Area of Science:

• Cardiology
• Sports Medicine
• Exercise Physiology

Background:

• Early repolarization (ER) is an electrocardiogram (ECG) finding.
• Its prevalence and significance in athletic populations, particularly middle-aged endurance athletes, require further investigation.

Purpose of the Study:

• To determine the prevalence and characteristics of ER in middle-aged male long-distance runners.
• To examine the relationship between ER and cardiac structure/function.
• To assess the impact of strenuous exercise on ER patterns.

Main Methods:

• 151 male runners (>45 years) underwent pre-race assessments including ECG, vectorcardiography, and echocardiography.
• 47 runners were reassessed post-race.
• ER was defined by ST elevation or J waves; morphology and localization were categorized.

Main Results:

• 44% of subjects exhibited ER.
• ER was associated with lower resting heart rate, lower BMI, higher training volume, and faster race times.
• Vectorcardiography revealed increased repolarization heterogeneity in subjects with ER.
• ER resolved in 75% of subjects post-exercise.

Conclusions:

• Early repolarization is a frequent finding in middle-aged male runners.
• This ECG pattern correlates with excellent physical conditioning and normal cardiac function.
• The transient nature of ER after strenuous exercise supports its classification as a training-related adaptation.