ST-Segment Elevation and T-Wave Inversion Confined to V1-V4 in Young Soccer Players: Prevalence and Differences from Afro-Brazilians to Ghanaians

Type of funding sources: Foundation. Main funding source(s): Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Hospital de Clínicas de Porto Alegre Research and Event Incentive Fund (FIPE-HCPA)

Black athletes may present some peculiarities in the resting 12-lead electrocardiogram, such as T-wave inversion (TWI) confined to V1-V4 preceded by ST-segment and J-point elevation (‘domed’ ST-elevation and TWI in V1-V4), the so-called Afro-Caribbean pattern, a benign variant of the athlete's heart according to the "2017 International criteria for electrocardiographic interpretation in athletes". However, the prevalence of these findings in young Afro-Brazilian (AB) soccer players is unknown.

To compare the prevalence of ‘domed’ ST-elevation and TWI in V1-V4 among young AB soccer players with Ghanaians black soccer players.

We sought to do this analysis visually, as the data from AB soccer players were as raw data; and those from Ghana’s were else aggregated. A forest plot with the point estimate and confidence intervals at 95% was built and, whenever any region from the lower limit up to the upper limit of the confidence interval of a given variable interpolate to the other, no differences could be claimed. The forest plot was built at R v. 4.1.2 using the package "metafor".

Data from 517 young AB soccer players (mean age: 20 years) and 159 young black soccer players from Ghana (mean age: 19 years) were evaluated and compared. The average height and weight were similar (177.2 cm and 70.7 kg for AB, and 175.2 cm and 68.4kg for Ghanaians players). Ghanaians had a significant higher prevalence of ‘domed’ ST-elevation and TWI in V1-V4 than AB (16.7%; 95% CI, 13.1 to 25.8 versus 2.1%; 95% CI, 1.2 to 3.9, respectively).

To the best of our knowledge, this is the first study to describe the low prevalence of the ‘domed’ ST-elevation combined with TWI in V1-V4 in young AB soccer players. Interestingly, when compared to Ghanaians young soccer players (all of them black African individuals), AB athletes presented a significant lower frequency of this finding (16.7% versus 2.1%). Finally, we hypothesize that ‘domed’ ST-elevation and TWI in V1-V4 seen in African athletes appears to become less prevalent in the generations after the time of migration from Africa to Brazil. Whether this is due to environmental or genetic changes, further studies should clarify.