This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Serra-Grima, R. Articles by Prat, T. Search for Related Content PubMed PubMed Citation Articles by Serra-Grima, R. Articles by Prat, T.

CLINICAL STUDY: ELECTROPHYSIOLOGY

Marked ventricular repolarization abnormalities in highly trained athletes’ electrocardiograms: clinical and prognostic implications

Ricard Serra-Grima, MD, Montserrat Estorch, MD, Ignasi Carrió, MD, Maite Subirana, MD^*, Lluís Bernà, MD and Teresa Prat, MD^*

^* Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
Department of Nuclear Medicine, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
Centre d’Estudis d’Alt Rendiment Esportiu (CEARE), Barcelona, Spain

Manuscript received June 22, 1999; revised manuscript received March 21, 2000, accepted May 24, 2000.

Reprint requests and correspondence: Ricard Serra-Grima, Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Pare Claret 167, 08025 Barcelona, Spain
arodrigo{at}hsp.santpau.es

OBJECTIVE

We sought to study the functional, clinical and prognostic implications of marked repolarization abnormalities (MRA) sometimes seen in athletes’ electrocardiograms (ECGs).

BACKGROUND

The clinical meaning of ECG MRA in athletes is unknown. No relationship has been drawn between either training intensity or any particular type of sport and MRA. Athletes are usually symptom free and do not show any decrease in their physical performance. It is as yet unclear whether MRA may have a negative effect on the performance of such athletes in competitive sports.

METHODS

We studied 26 athletes with MRA (negative T waves 2 mm in three or more ECG leads at rest). No athletes presented clinical symptoms of cardiac disease or decrease in their physical performance. Clinical and physical examinations, ECG at rest, exercise test and echocardiographic and antimyosin studies were performed in all athletes. Rest/exercise myocardial perfusion single-photon emission computed tomography studies were performed in 17 athletes. The follow-up ranged from 4 to 20 years (mean 6.7 years).

RESULTS

Four athletes were excluded due to hypertrophic cardiomyopathy. Echocardiographic studies showed right and left normal ventricular dimensions for highly conditioned athletes. In the exercise test, heart rate was 166 ± 12.4 beats/min, and exercise tolerance was 15.2 ± 2.7 metabolic equivalents of the task. All athletes had ECG at rest simulating myocardial ischemia or "pseudoischemia" with a tendency to normalize during exercise. Myocardial perfusion studies were normal in the studied athletes. Antimyosin studies showed mild and diffuse myocardial radiotracer uptake in 15 athletes (68%). No adverse clinical events were observed in the follow-up.

CONCLUSIONS

These results suggest that MRA have no clinical or pathological implications in athletes and should, therefore, not preclude physical training or participation in sporting events.

Abbreviations and Acronyms   ECG = electrocardiogram   In = indium   LV = left ventricle, left ventricular   MRA = marked repolarization abnormalities   Tc = technetium

This article has been cited by other articles:

				A. Pelliccia, F. M. Di Paolo, F. M. Quattrini, C. Basso, F. Culasso, G. Popoli, R. De Luca, A. Spataro, A. Biffi, G. Thiene, et al. Outcomes in Athletes with Marked ECG Repolarization Abnormalities N. Engl. J. Med., January 10, 2008; 358(2): 152 - 161. [Abstract] [Full Text] [PDF]

				E. Kasikcioglu The role of echocardiography screening in athletes for cardiovascular disease Eur J Echocardiogr, March 1, 2006; 7(2): 182 - 183. [Full Text] [PDF]

				C.E. Chee, C.P. Anastassiades, A.G. Antonopoulos, A.A. Petsas, and L.C. Anastassiades Cardiac hypertrophy and how it may break an athlete's heart - the Cypriot case Eur J Echocardiogr, August 1, 2005; 6(4): 301 - 307. [Abstract] [Full Text] [PDF]

				B. J. Maron Sudden Death in Young Athletes N. Engl. J. Med., September 11, 2003; 349(11): 1064 - 1075. [Full Text] [PDF]

				H. Heidbuchel, J. Hoogsteen, R. Fagard, L Vanhees, H. Ector, R. Willems, and J. Van Lierde High prevalence of right ventricular involvementin endurance athletes with ventricular arrhythmias: Role of an electrophysiologic study in risk stratification Eur. Heart J., August 2, 2003; 24(16): 1473 - 1480. [Abstract] [Full Text] [PDF]