Anterior T-Wave Inversion in Young White Athletes and Nonathletes

Malhotra, Aneil; Dhutia, Harshil; Gati, Sabiha; Yeo, Tee Joo; Dores, Hélder; Bastiaenen, Rachel; Narain, Rajay; Merghani, Ahmed; Finocchiaro, Gherardo; Sheikh, Nabeel; Steriotis, Alexandros; Zaidi, Abbas; Millar, Lynne; Behr, Elijah R.; Tomé, Maite; Papadakis, Michael; Sharma, Sanjay

doi:10.1016/j.jacc.2016.10.044

Cited by 91 publications

(55 citation statements)

References 33 publications

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“…34,35 Finally, in our study we also observed greater T-wave amplitude at the finish-line evaluation as compared with ECG data collected the day before the competition, in absence of relevant differences between men and women. 36 During exercise T-wave magnitude tends to lessen, showing a marked increase in the first minutes of recovery. 37,38 R-and T-wave amplitudes have opposite responses to stress, consisting, respectively, in a bump and a dip at the early recovery stage.…”

mentioning

confidence: 99%

The acute impact of an ultramarathon on right heart: A 12‐lead ECG study

D’Ascenzi

Anselmi

Ceccon

et al. 2019

Scandinavian Med Sci Sports

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Background Some concerns exist about possible detrimental effects on cardiac function of ultra‐endurance competitions. The aim of this study was to evaluate the acute effects of an ultramarathon by comparing pre‐ and post‐race 12‐lead ECG features. Methods A total of 301 competitive athletes (mean age: 48 ± 9 years) running a 50‐km ultramarathon were analyzed. Twelve‐lead ECG was collected the day before the race and immediately at the finish line. According to the Italian law, athletes could have participated only after undergoing pre‐participation screening that ruled out the presence of an underlying heart disease. Results After the race a significant increase in P‐wave voltage (P < .001) and P‐wave duration (P < .001) was found as compared to pre‐race data with a higher percentage of athletes fulfilling the ECG criteria for right atrial enlargement (RAE; from 3% to 17%, P < .001). The presence of RAE post‐race significantly correlated with age, hours of training/week, and years of training and inversely with time at the finish line and the final position in the ranking. T‐wave and R‐wave amplitude (P < .001) and QTc‐interval duration (P < .001) significantly increased after the race. No significant differences in terms of supraventricular or ventricular arrhythmias were found. Conclusions A sizeable proportion of athletes running a 50‐km ultramarathon demonstrated post‐race ECG signs of right heart overload but no arrhythmias. This finding supports the hypothesis that ultra‐endurance races may induce transient right heart overload.

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mentioning

confidence: 99%

The acute impact of an ultramarathon on right heart: A 12‐lead ECG study

D’Ascenzi

Anselmi

Ceccon

et al. 2019

Scandinavian Med Sci Sports

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“…Whether this is as a result of genetics, hormones or exercise ability is unclear. Conversely, female athletes show a higher prevalence of anterior TWI extending beyond V2 and a longer QT interval compared to male athletes [31][32][33].…”

Section: The Female Athletementioning

confidence: 86%

“…Common findings include sinus bradycardia and the ERP. An important finding, due to its overlap with arrhythmogenic cardiomyopathy of the right ventricular form, is anterior TWI extending to V3, which is much more common when compared to strength athletes [33].…”

Section: The Endurance Athletementioning

confidence: 99%

Current understanding of the electrocardiographic manifestations of the ?athlete?s heart?.

Parry-Williams¹,

Sharma²

2017

cardiology

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“…Patients with myocarditis may present with unspecific ST-elevations, PQ-depression, QTc prolongation or T-wave inversion, which, in some cases, might be difficult to distinguish from normal variants in healthy athletes (Table 1) (25,26). In our recent report looking at the prognostic value of CMR tissue characterization in risk stratifying patients with suspected A c c e p t e d m a n u s c r i p t 7 myocarditis, only 42% of the 670 suspected myocarditis patients showed abnormal ECGs, with no significant difference between those where LGE was present and absent (8).…”

Section: Electrocardiogrammentioning

confidence: 99%

Myocarditis in Athletes Is a Challenge

Eichhorn

Bière

Schnell³

et al. 2020

JACC: Cardiovascular Imaging

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Presentation of myocarditis in athletes is heterogeneous and establishing the diagnosis is challenging with no current uniform clinical gold-standard. The combined information from symptoms, electrocardiography, laboratory testing, echocardiography, cardiac magnetic resonance imaging (CMR), and in certain cases endomyocardial biopsy (EMB) helps to establish the diagnosis. Most patients with myocarditis recover spontaneously; however, athletes may be at higher risk of adverse cardiac events. Based on scarce evidence and mainly autopsy studies and expert's opinions, current recommendations generally advise abstinence from competitive sports ranging from 3 to 6 months. However, the dilemma poses that (un-) necessary prolonged disqualification of athletes in order to avoid adverse cardiac events, can cause considerable disruption to training schedules and tournament preparation, and leading to a decline in performance and ability to compete. Therefore, better risk stratification tools are needed. Using latest available data, this review contrasts existing recommendations and presents a new proposed diagnostic flowchart putting a greater focus on the use of CMR imaging in athletes with suspected myocarditis. This may enable cardiac caregivers to risk stratify athletes with suspected myocarditis more systematically, and furthermore allow for pooling of more unified data. To modify recommendations regarding sports behavior in athletes with myocarditis, more evidence, based on large multicenter registries including CMR and EMB, is needed. In the future, physicians might rely on combined novel risk stratification methods, by implementing both noninvasive-and invasive tissue characterization methods.

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Anterior T-Wave Inversion in Young White Athletes and Nonathletes

Cited by 91 publications

References 33 publications

The acute impact of an ultramarathon on right heart: A 12‐lead ECG study

The acute impact of an ultramarathon on right heart: A 12‐lead ECG study

Current understanding of the electrocardiographic manifestations of the ?athlete?s heart?.

Myocarditis in Athletes Is a Challenge

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