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Electrocardiographic findings in female endurance athletes
A Stolt1, U M Kujala, J Karjalainen
1Unit for Sports and Exercise Medicine, University of Helsinki, Finland.
Objective:
To determine the prevalence of aberrations in the resting electrocardiogram (ECG) in female athletes.
Design:
Case-control study.
Participants:
Thirty female endurance athletes and 30 age-matched nonobese nonathletic control subjects.
Main Outcome Measures:
Different measurements based on resting ECGs.
Main Results:
The athletes had lower heart rate (mean 53 +/- SD 7) than the controls (67 +/- 11; p < 0.0001), but no group difference was found in atrioventricular conduction (PQ interval). Cornell voltage (RaVl + SV3) reflecting left ventricular mass was higher in athletes (1.18 +/- 0.58 mV vs. 0.78 +/- 0.41 mV; p = 0.0030), but the deviations from normal limits were small. The index reflecting right ventricular mass (RV1 + SV5) was higher in athletes (0.58 +/- 0.23 mV) than controls (0.45 +/- 0.23 mV; P = 0.036) but did not exceed the criterion for right side hypertrophy. QRS duration was slightly prolonged in athletes (99 +/- 10 ms vs. 92 +/- 9 ms; p = 0.010), as were rate-adjusted QT intervals (p < 0.05). J-point elevations (p = 0.0062) and ST-segment elevations (p = 0.013) were seen more frequently in athletes, but were usually small.
Conclusions:
The female athlete's ECG differs less from control subjects than has been reported in male athletes. Extrathoracal anatomic considerations may explain some of the sex differences. However, when clear-cut ECG abnormalities are observed in female athletes, organic heart disease must be carefully excluded.