Echocardiographic findings in 2261 peri-pubertal athletes with or without inverted T waves at electrocardiogram

Calò, Leonardo; Sperandii, Fabio; Martino, Annamaria; Guerra, Emanuele; Cavarretta, Elena; Quaranta, Federico; Ruvo, Ermenegildo De; Sciarra, Luigi; Parisi, Attilio; Nigro, Antonia; Spataro, Antonio; Pigozzi, Fabio

doi:10.1136/heartjnl-2014-306110

Cited by 45 publications

(34 citation statements)

References 28 publications

(46 reference statements)

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“…As such, this paper by Calo et al 8 advances our understanding of TWI in athletes in several ways. First, their data demonstrate that TWI confined to the anterior leads are common among young Caucasian athletes and are highly unlikely to reflect clinically relevant disease.…”

Section: Novel Insights Into Athletic T-wave Inversionsmentioning

confidence: 86%

“…Calo et al 8 present data that provide some novel insights into athletic TWI. This investigative group from Italy examined the incidence, 12-lead territorial distribution, and echocardiographic correlates of TWI in a sizeable cohort (n=2261) of adolescent male football athletes.…”

Section: Novel Insights Into Athletic T-wave Inversionsmentioning

confidence: 99%

“…Without question, we are in need of more work to determine how best to address TWI across the spectrum of athletes and highly active patients. Future efforts should follow the lead of Calo et al 8 by pairing ECG data with non-invasive imaging and should ideally be conducted in a longitudinal fashion with ample numbers to assess clinical outcomes. As we wait such work, sheep and wolves will continue to co-mingle and may very well borrow one another's clothes.…”

Section: More Questions Than Answersmentioning

confidence: 99%

See 2 more Smart Citations

T-wave inversions in athletes: a sheep in wolf's clothing?

Wasfy

Baggish

2014

Heart

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Section: Novel Insights Into Athletic T-wave Inversionsmentioning

confidence: 86%

Section: Novel Insights Into Athletic T-wave Inversionsmentioning

confidence: 99%

Section: More Questions Than Answersmentioning

confidence: 99%

See 1 more Smart Citation

T-wave inversions in athletes: a sheep in wolf's clothing?

Wasfy

Baggish

2014

Heart

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“…Athletes of Afro-Caribbean origin, who comprised 20% of Sheikh's study group, are more likely to present TWI than are Caucasians [10,27]. Many publications based on additional tests such as echocardiography and cardiac magnetic resonance revealed that TWI is closely associated with cardiac diseases, particularly with HCM [28][29][30][31]. In the cited paper, the TWI was present in 97% of athletes with diagnosed HCM [10].…”

Section: Discussionmentioning

confidence: 96%

The differences in electrocardiogram interpretation in top-level athletes

et al. 2017

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A b s t r a c tBackground: The Ministry of Health in Poland recommends electrocardiogram (ECG)-based cardiovascular screening in athletes, but so far there has been a lack of guidelines on preparticipation assessment. We compared different criteria of ECG screening assessment in a group of top-level athletes. Aim:The aims were to evaluate the prevalence of ECG changes in athletes that necessitate further cardiological work-up according to three criteria in various age groups as well as to identify factors determining the occurrence of changes related and unrelated to the training.Methods: 262 high-dynamic, high-static Polish athletes (rowers, cyclists, canoeists) were divided into two age categories: young (≤ 18 years of age; n = 177, mean age 16.9 ± 0.8; 15-18 years) and elite (> 18 years of age; n = 85, mean age 22.9 ± 3.4; 19-34 years). All sports persons had a 12-lead ECG performed and evaluated according to 2010 European Society of Cardiology (ESC) recommendations, 2012 Seattle criteria, and 2014 Refined criteria. Results:The Refined criteria reduced (p < 0.001) the number of training-unrelated ECG findings to 8.0% vs. 12.6% (Seattle criteria) and 30.5% (ESC recommendations). All three criteria revealed more training-related changes in the group of older athletes (76.5% vs. 55.9%, p = 0.001). Predictors that significantly (p < 0.005) affected the occurrence of adaptive changes were the age of the athlete, training duration (in years), and male gender.Conclusions: 1. The ESC criteria identified a group of athletes that was unacceptably large, as for the screening test, requiring verification with other methods (every fourth athlete). 2. The use of the Refined criteria helps to significantly reduce the frequency and necessity for additional tests. 3. The dependence of adaptive changes on training duration and athletes' age confirms the benign nature of those ECG findings.

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“…This cut-off did not improve diagnostic ability compared with the presence of negative T-wave in more than 2 contiguous ECG leads; this was due to a high Pearson correlation (0.76, p b 0.01) between these two parameters. Therefore, spatial QRS-T angle seems to be a useful quantitative value, but as a binary parameter it is less useful to establish a differential diagnosis with a likelihood ratio similar to the presence of TWI in HCM [22] or to the localization of the TWI in inferior-lateral leads [23].…”

Section: Discussionmentioning

confidence: 98%