Dataset Information

Early repolarization in adolescent athletes: A gender comparison of ECG and echocardiographic characteristics.

ABSTRACT:

Background

The early repolarization pattern (ERp) is an electrocardiographic finding previously associated with arrhythmic risk in adults. The purpose of this study is to evaluate the prevalence and characteristics of ERp in a group of adolescent athletes according to gender. Furthermore, potential associations with clinical, electrocardiographic, and echocardiographic parameters are explored.

Methods

In this cross-sectional study young athletes (age < 18 years) were consecutively enrolled during the annual pre-participation evaluation, undergoing also transthoracic echocardiography assessment from January 2015 to March 2020.

Results

The prevalence of ERp was 27% in the whole population. Athletes with ERp were more frequently men practicing endurance sports. Women with ERp showed lower heart rate at rest, greater posterior, and relative ventricular wall thickness than those without ERp. Men with ERp presented higher systolic blood pressure at peak exercise, greater septal wall thickness, and indexed left ventricular mass than those without ERp. Both genders with ERp showed increased QRS voltage and narrower QRS duration. The ERp phenotype in men was more frequently notched with higher amplitude and ascending ST segment. Women's ERp presented more frequently a slurred morphology, especially in the inferior leads, and horizontal ST slope. No differences emerged in the occurrence of arrhythmias at rest and during maximal exercise test between groups, even considering higher risk phenotypes.

Conclusions

ERp is an ECG finding compatible with normal cardiac adaptations to training in young athletes. ERp demonstrated gender differences regarding phenotypes previously associated with increased cardiovascular risk, not showing any differences in arrhythmias during maximal exercise test.

SUBMITTER: Vecchiato M

PROVIDER: S-EPMC9826079 | biostudies-literature | 2022 Nov

REPOSITORIES: biostudies-literature

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Publications

Early repolarization in adolescent athletes: A gender comparison of ECG and echocardiographic characteristics.

Vecchiato Marco M Baioccato Veronica V Adami Paolo Emilio PE Quinto Giulia G Foccardi Giulia G Slanzi Giulio G Battista Francesca F Neunhaeuserer Daniel D Ermolao Andrea A

Scandinavian journal of medicine & science in sports 20220915 11

<h4>Background</h4>The early repolarization pattern (ERp) is an electrocardiographic finding previously associated with arrhythmic risk in adults. The purpose of this study is to evaluate the prevalence and characteristics of ERp in a group of adolescent athletes according to gender. Furthermore, potential associations with clinical, electrocardiographic, and echocardiographic parameters are explored.<h4>Methods</h4>In this cross-sectional study young athletes (age < 18 years) were consecutively ...[more]

PMID: 36086882

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Project description:Background Early repolarization pattern (ERP) is considered a common training-related and benign ECG finding in young adult athletes. Few data exist on ERP in the pediatric athletes population. Therefore, we aimed to evaluate the ERP prevalence, characteristics, and prognosis in pediatric athletes aged ≤16 years. Methods and Results Eight-hundred eighty-six consecutive pediatric athletes engaged in 17 different sports (mean age, 11.7±2.5 years; 7-16 years) were enrolled and prospectively evaluated with medical history, physical examination, resting and exercise ECGs, and transthoracic echocardiography during their preparticipation screening. Known cardiovascular diseases associated with sudden cardiac death was considered exclusion criteria. Athletes were followed up yearly for 4 years. The prevalence of ERP was 117 (13.2%), equally distributed in both sexes (P=0.072), irrespectively of body mass index and classification of sports. The most common ERP localizations were inferolateral and inferior leads (53.8% and 27.3%, respectively). Notching J-point morphology was the most prevalent (70%), and rapidly ascending ST elevation (96%) was the most common ST-segment morphology. Athletes with ERP were older (P<0.001) had lower rest and recovery heart rates (P<0.001), increased precordial and limb R-wave voltages (P<0.001), increased R/S Sokolow index (P<0.001), and longer PR interval (P=0.006) in comparison with the athletes without ERP. Neither major cardiovascular nor arrhythmic events, nor sudden cardiac death were recorded over a median follow-up of 4.2 years. One hundred seventeen (80.3%) athletes with ERP exhibited a persistent ERP. ERP localization and J-point morphology changed during follow-up in 11 (11.7%) and 17 (18%) of athletes, respectively. Conclusions ERP is common in pediatric athletes. It was mostly located in the inferolateral leads and associated with concave ascending ST segment with other training-related ECG changes. The lack of either sudden cardiac death or cardiomyopathies linked to sudden cardiac death over follow-up suggests that in pediatric athletes, ERP may be considered a benign training-related ECG phenomenon with a potential dynamic pattern.

Project description:PurposeThe aims of this study were to (1) quantify the multidimensional attributes of male and female basketball athletes under 16 years of age (U16) and under 18 years of age (U18), and (2) identify attributes that distinguish selection into a talent pathway according to sex and age group.Methods67 male and 71 female athletes competing in U16 and U18 selection trials for a state based Australian basketball talent pathway completed a multidimensional testing battery. The test battery consisted of anthropometric, physical (20- linear sprint, countermovement jump height, Yo-Yo Intermittent Recovery Test Level 2), technical (Basketball Jump Shooting Accuracy Test), tactical (video decision making), and psychological (Sports Orientation Questionnaire, Psychological Performance Inventory-Alternative) assessments. Mean differences and independent t-tests were used to assess comparative differences between selected and non-selected athletes within each age and sex cohort. Stepwise discriminant analyses were used to identify attributes that were the strongest discriminators of selection in each group (male U16, male U18, female U16, and female U18).ResultsThe discrimminant models showed for male U16 athletes smaller height (ES = -0.18) and greater shooting accuracy (ES = 0.52) was most discriminant of selection. Results were largely homogenous for male U18 athletes with lower visualisation score (ES = -0.62) most discriminant of selection. In female cohorts, faster 20-m sprint time (ES = -0.66) and taller height (ES = 0.58) was most discriminant of selection in U16 athletes while greater shooting accuracy (ES = 0.67), countermovement jump height (ES = 1.04), and height (ES = 0.65) was most discriminant of selection in U18 athletes.ConclusionsThese results emphasise the differing selection priorities within adolescent basketball cohorts according to sex and age group. The testing of anthropometric, physical and technical attributes may hold particular utility in adolescent female basketball given their identified importance to selection across U16 and U18 cohorts.

Project description:BackgroundAthletes can experience exercise-induced transient arrythmias during high-intensity exercise or competition, which are difficult to capture on traditional Holter monitors or replicate in clinical exercise testing. The aim of this study was to investigate the reliability of a portable single channel ECG sensor and data recorder (PluxECG) and to evaluate the confidence and reliability in interpretation of ECGs recorded using the PluxECG during remote rowing.MethodsThis was a two-phase study on rowing athletes. Phase I assessed the accuracy and precision of heart rate (HR) using the PluxECG system compared to a reference 12-lead ECG system. Phase II evaluated the confidence and reliability in interpretation of ECGs during ergometer (ERG) and on-water (OW) rowing at moderate and high intensities. ECGs were reviewed by two expert readers for HR, rhythm, artifact and confidence in interpretation.ResultsFindings from Phase I found that 91.9% of samples were within the 95% confidence interval for the instantaneous value of the changing exercising HR. The mean correlation coefficient across participants and tests was 0.9886 (σ = 0.0002, SD = 0.017) and between the two systems at elevated HR was 0.9676 (σ = 0.002, SD = 0.05). Findings from Phase II found significant differences for the presence of artifacts and confidence in interpretation in ECGs between readers' for both intensities and testing conditions. Interpretation of ECGs for OW rowing had a lower level of reader agreement than ERG rowing for HR, rhythm, and artifact. Using consensus data between readers' significant differences were apparent between OW and ERG rowing at high-intensity rowing for HR (p = 0.05) and artifact (p = 0.01). ECGs were deemed of moderate-low quality based on confidence in interpretation and the presence of artifacts.ConclusionsThe PluxECG device records accurate and reliable HR but not ECG data during exercise in rowers. The quality of ECG tracing derived from the PluxECG device is moderate-low, therefore the confidence in ECG interpretation using the PluxECG device when recorded on open water is inadequate at this time.

Dataset Information

Early repolarization in adolescent athletes: A gender comparison of ECG and echocardiographic characteristics.

Background

Methods

Results

Conclusions

Publications

Early repolarization in adolescent athletes: A gender comparison of ECG and echocardiographic characteristics.

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