Electro-echocardiographic correlation in high-performance athletes

Abstract

Background: Functional and structural cardiac adaptations are generated by sustained physical training. The objective of our investigation was to evaluate the association in electrocardiographic and echocardiographic findings in a population of high-performance athletes. Material and method: 30 male athletes (10 water polo players, 10 triathlonists and 10 swimmers), ages 18 to 40 years old, training 20 to 30 hours per week for at least one year, were evaluated. Clinical, electrocardiographic (ECG) and echocardiographic examination was performed on each of them at Instituto Vozzi. Results: Echocardiographic results showed that the mean septal thickness, the mass index of the left ventricle (LV), the anteroposterior diameter and the area of the left atrium (LA), the area of the right atrium (RA) and the base of the right ventricle (RV) were found above normal values for the general population. None of the athletes ECGs presented LA, RA or RV enlargement. Nine of 30 (30%) presented signs of LV enlargement. After adjusting for age, weight, height, body surface area, and sport performed, LV diastolic diameter (LVDD) indexed to body surface area (BSA) was higher in athletes with LV enlargement on ECG (adjusted mean 28.94 ± 0.56 mm; 95% CI = 27.78-30.10) vs without (27.67 ± 0.36 mm; 95% CI = 26.93-28.41). More triathlonists presented LV enlargement signs on the ECG compared to the other groups. Conclusions: Certain echocardiographic parameters in our population of athletes are above normal values for the general population. There was no relationship comparing electrocardiographic and echocardiographic signs of LA, RA and RV enlargement. An association was found between ECGs LV enlargement and increased LVDD indexed to BSA on the echocardiograms. LV enlargement on the ECGs was more frequent in the triathlon group.