The early repolarization pattern: Echocardiographic characteristics in elite athletes

Area of Science:

• Cardiology
• Sports Medicine
• Exercise Physiology

Background:

• Early repolarization (ER) pattern on ECG is linked to ventricular fibrillation and cardiovascular mortality.
• The influence of cardiac structure on ER phenotype is not well understood.
• ER is frequently observed in athletes, necessitating investigation in this population.

Purpose of the Study:

• To determine the prevalence of ER in elite athletes.
• To investigate echocardiographic characteristics associated with ER.
• To assess cardiopulmonary exercise capacity in athletes with and without ER.

Main Methods:

• A cohort of 623 elite athletes underwent ECG, echocardiography, and exercise testing.
• ECGs were analyzed for the presence of ER.
• Clinical follow-up was conducted for all participants.

Main Results:

• ER prevalence was 17% (108/623 athletes).
• ER-positive athletes were predominantly male, leaner, and had lower heart rates.
• Most echocardiographic and exercise capacity measures were similar between ER-positive and ER-negative athletes, except for the notching ER subtype.

Conclusions:

• Early repolarization in elite athletes is not associated with significant echocardiographic alterations or reduced cardiopulmonary exercise capacity.
• Athletes with ER are characterized by male sex, lean body mass, and lower heart rates.
• No severe cardiovascular events occurred during follow-up, suggesting ER in athletes may have a benign clinical course.