Electrocardiographic anterior T-wave inversion in athletes of different ethnicities: differential diagnosis between athlete's heart and cardiomyopathy

Calore, Chiara; Zorzi, Alessandro; Sheikh, Nabeel; Nese, Alberto; Facci, M; Malhotra, Aneil; Zaidi, Abbas; Schiavon, Maurizio; Pelliccia, Antonio; Sharma, Sanjay; Corrado, Domenico

doi:10.1093/eurheartj/ehv591

Cited by 93 publications

(66 citation statements)

References 31 publications

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“…In addition, according to current International criteria, T-wave inversion confined to V1–V4 and preceded by J-point elevation is considered normal only in black athletes. According to the present and a previous study,29 such ECG finding can also be found in white athletes while it is never observed in patients with HCM. These findings, if confirmed by other studies from different groups, may lead to further refinement of the criteria for interpretation of the ECG of Caucasian athletes.…”

Section: Discussionsupporting

confidence: 69%

Accuracy of the ECG for differential diagnosis between hypertrophic cardiomyopathy and athlete’s heart: comparison between the European Society of Cardiology (2010) and International (2017) criteria

et al. 2017

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Section: Discussionsupporting

confidence: 69%

Accuracy of the ECG for differential diagnosis between hypertrophic cardiomyopathy and athlete’s heart: comparison between the European Society of Cardiology (2010) and International (2017) criteria

et al. 2017

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“…Anterior TWI is a normal variant in asymptomatic adolescent athletes age <16 years and in black athletes when preceded by J-point elevation and convex ST segment elevation 84. Anterior TWI involving lead V3 is also reported in white, adult, predominantly endurance athletes 63.…”

Section: Abnormal Ecg Findings In Athletesmentioning

confidence: 98%

International criteria for electrocardiographic interpretation in athletes: Consensus statement

et al. 2017

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Sudden cardiac death (SCD) is the leading cause of mortality in athletes during sport. A variety of mostly hereditary, structural or electrical cardiac disorders are associated with SCD in young athletes, the majority of which can be identified or suggested by abnormalities on a resting 12-lead electrocardiogram (ECG). Whether used for diagnostic or screening purposes, physicians responsible for the cardiovascular care of athletes should be knowledgeable and competent in ECG interpretation in athletes. However, in most countries a shortage of physician expertise limits wider application of the ECG in the care of the athlete. A critical need exists for physician education in modern ECG interpretation that distinguishes normal physiological adaptations in athletes from distinctly abnormal findings suggestive of underlying pathology. Since the original 2010 European Society of Cardiology recommendations for ECG interpretation in athletes, ECG standards have evolved quickly, advanced by a growing body of scientific data and investigations that both examine proposed criteria sets and establish new evidence to guide refinements. On 26-27 February 2015, an international group of experts in sports cardiology, inherited cardiac disease, and sports medicine convened in Seattle, Washington (USA), to update contemporary standards for ECG interpretation in athletes. The objective of the meeting was to define and revise ECG interpretation standards based on new and emerging research and to develop a clear guide to the proper evaluation of ECG abnormalities in athletes. This statement represents an international consensus for ECG interpretation in athletes and provides expert opinion-based recommendations linking specific ECG abnormalities and the secondary evaluation for conditions associated with SCD.

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“…Iako su u većini slučajeva gore navedene adaptivne promene sindroma sportskog srca asimptomatske, u 3-5% slučajeva mogu da daju promene na elektrokardiografskom zapisu (EKG) ili utrazvučnoj dijagnostici, testovima opterećenja i magnetnoj rezonanci (24,25,26).…”

Section: Klinički Aspekt Sindroma Sportskog Srcaunclassified

“…Elektrokardiografske studije su ukazale da se adaptivne promene sportskog srca mogu uočiti na EKG zapisima vrhunskih sportista, zbog čega i zato je elektrokardiografija obavezan deo pregleda sportista (25). Treba, međutim, imati na umu da je 50-60% EKG zapisa normalno kod vrhunskih sportista muškog pola i kod 75-80% ženskog pola uzrasta 12-40 godina (24).…”

Section: Klinički Aspekt Sindroma Sportskog Srcaunclassified

“…Uopšteno, u poređenju sa sedentarnom populacijom, učestali nalazi na EKG kod (27). Kod sportista se često javlja visok T-talas koji mora da bude pozitivan u svim odvodima, a može da bude negativan u aVR, gde je uvek negativan i u III i V1 (25). Kod nekih sportista može se naći i nodalni ritam ili AV blok drugog stepena (Mobic tip 1) (26).…”

Section: Klinički Aspekt Sindroma Sportskog Srcaunclassified

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Athlete's heart syndrome: A friend or foe?

Delić¹

2016

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SažetakSindrom sportskog srca je skup morfoloških i funkcionalnih adaptivnih promena srca i, posledično, kardiovaskularnog sistema kao fiziološkog odgovora na kontinuiranu i intenzivnu fizičku aktivnost. Smatra se da je ovaj sindrom "siva zona" između fiziologije i patologije, dakle nedovoljno poznat i samim tim podložan različitim tumačenjima. Poslednjih nekoliko godina smo bili svedoci nekolicine iznenadnih smrti vrhunskih mladih sportista na terenu koje su dovođene u vezu sa sindromom sportskog srca. Interes pobuđen ovim tragičnim događajima izazvao je brojne rasprave u stručnoj javnosti i naveo na dilemu: "Da li je fizološka adaptivna promena kao što je sportsko srce prijatelj ili neprijatelj sportista?" U ovom revijskom radu ćemo pokušati da damo neke smernice koje su u vezi sa ovom dilemom.Ključne reči: sindrom sportsko srce, iznenadna srcana smrt, vrhunski sportisti AbstractAthlete's heart syndrome is a set of morphological and functional adaptive changes of the heart and consequently the cardiovascular system as a physiological response to chronic physical activity. It is believed that this syndrome is "gray zone" between physiology and pathology and therefore subject to different interpretations. In the last few years, we have some sudden cardiac deaths of elite young athletes that have been speculated and associated with the athlete's heart syndrome. There is an increase in the scientific research in this field and the debate among the experts with one dilemma: if these physiological adaptive changes, athlete's heart syndrome, is the athletes friend or foe? In this Review, we describe various types of athlete's heart syndrome-their developmental, biology, differentiation, cell heterogeneity and functional characteristics.

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Electrocardiographic anterior T-wave inversion in athletes of different ethnicities: differential diagnosis between athlete's heart and cardiomyopathy

Cited by 93 publications

References 31 publications

Accuracy of the ECG for differential diagnosis between hypertrophic cardiomyopathy and athlete’s heart: comparison between the European Society of Cardiology (2010) and International (2017) criteria

Accuracy of the ECG for differential diagnosis between hypertrophic cardiomyopathy and athlete’s heart: comparison between the European Society of Cardiology (2010) and International (2017) criteria

International criteria for electrocardiographic interpretation in athletes: Consensus statement

Athlete's heart syndrome: A friend or foe?

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