Early repolarization in adolescent athletes: A gender comparison of <scp>ECG</scp> and echocardiographic characteristics

Vecchiato, Marco; Baioccato, Veronica; Adami, Paolo Emilio; Quinto, Giulia; Foccardi, Giulia; Slanzi, Giulio; Battista, Francesca; Neunhäeuserer, Daniel; Ermolao, Andrea

doi:10.1111/sms.14232

Cited by 3 publications

(1 citation statement)

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“…Exclusion criteria were age > 18 years, known cardiac disease (congenital heart disease, cardiomyopathies, and arrhythmic syndromes), symptoms and ECG abnormalities. Data regarding medical history, physical examination, ECG characteristics, exercise testing, and transthoracic echocardiography were collected for each participant [ 13 ]. The local ethics committee approved this study (Code 129n/AO/21 – date 22.04.2021) and written informed consent was obtained from the parents of all athletes.…”

Section: Methodsmentioning

confidence: 99%

The Fragmented QRS Complex in Lead V1: Time for an Update of the Athlete’s ECG?

Vecchiato,

Quinto,

Borasio

et al. 2023

J. of Cardiovasc. Trans. Res.

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Differentiating between ECG patterns related to athletes' heart remodeling and pathological findings is a challenge in sports cardiology. As the significance of fragmented complex in athletes remains uncertain, this study aimed to assess the presence of fragmented QRS in lead V1 (fQRSV1) among young athletes and its association with heart adaptations and arrhythmias. Young athletes referred for annual pre-participation screening receiving a maximal exercise testing and transthoracic echocardiography from January 2015 to March 2021 were included. The study included 684 young athletes. The prevalence of fQRSV1 was 33%. Subjects with fQRSV1 had higher exercise capacity and indexes of right ventricular function and remodeling. Among highly trained athletes, the fQRSV1 group demonstrated also increased left ventricular wall thickness. No significant association existed between fQRSV1 and exercise-induced arrhythmias, even in highly trained athletes. The high prevalence of fQRSV1 in young athletes is associated with training-induced heart adaptations but not exercise-induced ventricular arrhythmias. Graphical Abstract The fragmented QRS complex in lead V1 in young athletes. PPS = preparticipation screening; EST = exercise stress test; fQRSV1 = fragmented QRS in lead V1; PSBs = premature supraventricular beats; PVBs = premature ventricular beats.

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Section: Methodsmentioning

confidence: 99%

The Fragmented QRS Complex in Lead V1: Time for an Update of the Athlete’s ECG?

Vecchiato,

Quinto,

Borasio

et al. 2023

J. of Cardiovasc. Trans. Res.

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Sex‐Specific Differences in Cardiovascular Adaptations and Risks in Elite Athletes: Bridging the Gap in Sports Cardiology

Afaghi,

Rahimi,

Soltani

et al. 2024

Clinical Cardiology

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BackgroundThe growing participation of women in competitive sports necessitates a comprehensive understanding of sex‐specific cardiovascular adaptations and risks. Historically, research has predominantly focused on male athletes, leaving a gap in knowledge about the unique cardiovascular dynamics of female peers.Hypothesiswe hypothesized that female athletes exhibit distinct cardiovascular adaptations and face different risks, influenced by physiological, hormonal, and structural differences.MethodsA systematic review of the literature was conducted, analyzing studies on cardiovascular responses and adaptations in athletes. Data were extracted on hemodynamic changes, autonomic and neural reflex regulation, cardiac remodeling, and arrhythmias. Comparative analyses were performed to identify sex‐specific patterns and discrepancies in cardiovascular health outcomes.ResultsWe revealed considerable sex differences in cardiovascular adaptations to athletic training. Female athletes generally have longer QT intervals, greater sinoatrial node automaticity, and enhanced atrioventricular node function compared to males. They also exhibit lower sympathetic activity, lower maximal stroke volumes, and a tendency toward eccentric cardiac remodeling. Conversely, male athletes are more prone to concentric hypertrophy and higher incidences of bradyarrhythmia and accessory pathway arrhythmias. Female athletes are more likely to experience symptomatic atrial fibrillation and face higher procedural complications during catheter ablation.ConclusionsOur findings underscore the necessity for sex‐specific approaches in sports cardiology. Recognizing and addressing these differences could enhance performance and reduce adverse cardiac events in athletes. Future research should focus on developing tailored screening, prevention, and treatment strategies to bridge the knowledge gap and promote cardiovascular health in both male and female athletes.

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Early repolarization in adolescent athletes: A gender comparison of ECG and echocardiographic characteristics

Vecchiato

Baioccato

Adami

et al. 2022

Scandinavian Med Sci Sports

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Background The early repolarization pattern (ERp) is an electrocardiographic finding previously associated with arrhythmic risk in adults. The purpose of this study is to evaluate the prevalence and characteristics of ERp in a group of adolescent athletes according to gender. Furthermore, potential associations with clinical, electrocardiographic, and echocardiographic parameters are explored. Methods In this cross‐sectional study young athletes (age < 18 years) were consecutively enrolled during the annual pre‐participation evaluation, undergoing also transthoracic echocardiography assessment from January 2015 to March 2020. Results The prevalence of ERp was 27% in the whole population. Athletes with ERp were more frequently men practicing endurance sports. Women with ERp showed lower heart rate at rest, greater posterior, and relative ventricular wall thickness than those without ERp. Men with ERp presented higher systolic blood pressure at peak exercise, greater septal wall thickness, and indexed left ventricular mass than those without ERp. Both genders with ERp showed increased QRS voltage and narrower QRS duration. The ERp phenotype in men was more frequently notched with higher amplitude and ascending ST segment. Women's ERp presented more frequently a slurred morphology, especially in the inferior leads, and horizontal ST slope. No differences emerged in the occurrence of arrhythmias at rest and during maximal exercise test between groups, even considering higher risk phenotypes. Conclusions ERp is an ECG finding compatible with normal cardiac adaptations to training in young athletes. ERp demonstrated gender differences regarding phenotypes previously associated with increased cardiovascular risk, not showing any differences in arrhythmias during maximal exercise test.

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Early repolarization in adolescent athletes: A gender comparison of ECG and echocardiographic characteristics

Cited by 3 publications

References 48 publications

The Fragmented QRS Complex in Lead V1: Time for an Update of the Athlete’s ECG?

The Fragmented QRS Complex in Lead V1: Time for an Update of the Athlete’s ECG?

Sex‐Specific Differences in Cardiovascular Adaptations and Risks in Elite Athletes: Bridging the Gap in Sports Cardiology

Early repolarization in adolescent athletes: A gender comparison of ECG and echocardiographic characteristics

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