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Analysis of ECG repolarization parameters in young competitive athletes

Session Poster session 3

Speaker Assistant Professor Andrea Orosz

Congress : EHRA 2019

  • Topic : preventive cardiology
  • Sub-topic : Sports Cardiology: Electrocardiography (ECG)
  • Session type : Poster Session
  • FP Number : P1383

Authors : A Orosz (Szeged,HU), I Nikolic (Belgrade,RS), T Stojmenovic (Belgrade,RS), N Dikic (Belgrade,RS), I Nedeljkovic (Belgrade,RS), V Jakovljevic (Kragujevac,RS), A Nemes (Szeged,HU), C Lengyel (Szeged,HU), A Varro (Szeged,HU), I Baczko (Szeged,HU)


A Orosz1 , I Nikolic2 , T Stojmenovic2 , N Dikic2 , I Nedeljkovic3 , V Jakovljevic4 , A Nemes5 , C Lengyel6 , A Varro1 , I Baczko1 , 1University of Szeged, Faculty of Medicine, Department of Pharmacology & Pharmacotherapy - Szeged - Hungary , 2Special Hospital for Sports Medicine “Vita Maxima” - Belgrade - Serbia , 3Clinic for Cardiology, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade - Belgrade - Serbia , 4Department of Physiology, Faculty of Medical Sciences, University of Kragujevac - Kragujevac - Serbia , 5University of Szeged, Faculty of Medicine, 2nd Dept of Internal Medicine & Cardiology Center - Szeged - Hungary , 6University of Szeged, Faculty of Medicine, 1st Dept of Internal Medicine - Szeged - Hungary ,


Introduction: Sudden death among athletes is rare but it is significantly more frequent than in the normal population. In the majority of these cases the cause is not clearly established and is mostly attributed to ventricular fibrillation. Physical conditioning in competitive athletes induces cardiac hypertrophy which could be associated with increased propensity for ventricular arrhythmias. Recent data proved that ECG repolarization parameters, including QT variability may represent a novel marker in SCD risk assessment.

Purpose: In the present study we investigated ECG repolarization parameters, including QT variability in young athletes.

Methods: 105 professional athletes (age: 24±5 years) and 105 age-matched healthy volunteers who do not participate in competitive sports (age: 26±10 years) were enrolled in the study. Five-minute 12-lead resting electrocardiograms were recorded before and after treadmill exercise testing, the ECGs were digitized and evaluated off-line using the Cardiosys-A01 system. The following parameters were determined: the frequency corrected QT interval (QTc), QT dispersion (QTd), T wave peak-to-end distance (Tpeak-Tend). Among QT variability parameters we analyzed the QT variance normalized for QT mean, the QT variability index, the short-term beat-to-beat QT interval variability (STV-QT) and the long-term QT variability parameters based on constructed Poincaré plots.

Results: Heart rate was significantly lower in professional athletes at rest (61±10 vs. 71±12/min in controls, p?0.0001). The QT interval was prolonged in athletes at rest (423±32 vs. 390±33 ms in controls, p?0.0001). QTc was significantly longer in athletes before and after treadmill exercise testing compared to controls calculated with Framingham, Fridericia and Hodges correction formulas. However, the QTd (38±13 before and 36±11 ms after exercise vs. 35±11 ms in controls), Tpeak-Tend intervals at rest (96±13 vs. 99±24 ms in controls) did not differ significantly. Importantly, STV-QT was significantly higher in athletes both at rest and following treadmill exercise testing compared to controls (4.29±1.2 and 3.77±1.1 vs. 3.39±0.8 ms, both p?0.01, respectively).

Conclusion: Some of the alterations in repolarization parameters and the significant increase in STV-QT may indicate increased repolarization instability in competitive athletes compared to age-matched controls, however, further studies are needed to relate this finding to increased arrhythmia propensity in this population.

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