Influence of type of sport on cardiac repolarization assessed by electrocardiographic T-wave morphology combination score

Abstract

This study suggests that sport induces repolarization changes detected by T-wave morphology, and a greater level of changes is seen in athletes from high endurance sports.

Characterization of T Wave Amplitude, Duration and Morphology Changes During Hemodialysis: Relationship With Serum Electrolyte Levels and Heart Rate

“…Regarding the analysis of the T wave shape, a morphology combination score (MCS) based on T wave asymmetry, flatness and notching [45]- [47] has been used to analyze its relationship with [K + ] in a primary care population [48]. A clear association between MCS and [K + ] could only be found among individuals with [K + ] in the range 2-4.1 mM, but not among those with [K + ] in the range 4.2-6 mM.…”

Prolonged QT Interval in Athletes: Distinguishing between Pathology and Physiology

“…International recommendations for ECG in athletes were formulated without taking into account the results of Dagradi et al [2] that suggest detraining in all genotype-negative athletes with QTc prolongation to reclassify them as affected or not by LQTS according to the attendant changes in QTc and Schwartz score. Despite a seeming inconsistency in the literature about the comparison of QTc between athletes and nonathletes, the majority of well-designed studies displayed increased QTc in athletes [1,3,[18][19][20][21][22][23]. Moreover, the subgroup of athletes in these studies was characterized by much lower HR compared to nonathletes with a considerable proportion of athletes in the zone of less than 50 bpm that is associated with significant underestimation of QTc, tending to decrease the significance of the difference in QTc between athletes and nonathletes.…”

“…These pathological T wave inversions encountered in individuals with LQTS usually attract most attention of an ECG reader, potentially leading the reader to overlook the QT prolongation, if a systematic approach to ECG interpretation is not applied. However, increased prevalence of T wave abnormalities has been normally reported in athletes, especially in endurance athletes, further increasing the diagnostic challenges in ECG interpretation of athletes with T wave abnormalities and QTc prolongation [23].…”

“…Apart from one study that showed a downregulation of QTc in power athletes abusing androgenic anabolic steroids, the relevant studies did not report any information about the use of androgenic anabolic steroids (based either on history taking or on physical signs indicative of concealed use) that can considerably reduce QTc in athletes, counterbalancing the QTc prolonging effect of exercise training [1, 24]. The impact of the type of sports on QTc has not been adequately investigated, though the studies that found upregulation of QTc in athletes included mainly athletes with high endurance component of exercise training [1, 3, 19, 23]. Although the underlying mechanisms of the QTc prolongation due to exercise training have not been elucidated yet, a plausible mechanism involves the chronic upregulation of stretch-activated sarcolemmal Ca 2+ channels of cardiomyocytes in the context of exercise training-induced membrane deformation, leading to prolonged ventricular repolarization and thus QTc prolongation on the surface ECG [25, 26].…”

Risk of sudden cardiac death in strength training

“…Наличие ЭКГ-признаков гипертрофии ЛЖ, таких как увеличение вольтажа зубцов R и нарушений реполяризации, ассоциируется с повышенным риском ВСС [42]. Tischer SG, et al (2018) предполагают, что по большей части именно аэробные нагрузки влияют на реполяризацию, которую обнаруживают по зубцу Т на ЭКГ [44]. В отношении тренирующихся с сопротивлением достаточной информации в этом аспекте пока нет.…”