Background-The prevalence, clinical significance, and determinants of abnormal ECG patterns in trained athletes remain largely unresolved. Methods and Results-We compared ECG patterns with cardiac morphology (as assessed by echocardiography) in 1005 consecutive athletes (aged 24Ϯ6 years; 75% male) who were participating in 38 sporting disciplines. ECG patterns were distinctly abnormal in 145 athletes (14%), mildly abnormal in 257 (26%), and normal or with minor alterations in 603 (60%). Structural cardiovascular abnormalities were identified in only 53 athletes (5%). Larger cardiac dimensions were associated with abnormal ECG patterns: left ventricular end-diastolic cavity dimensions were 56.0Ϯ5.6, 55.4Ϯ5.7, and 53.7Ϯ5.7 mm (PϽ0.001) and maximum wall thicknesses were 10.1Ϯ1.4, 9.8Ϯ1.3, and 9.3Ϯ1.4 mm (PϽ0.001) in distinctly abnormal, mildly abnormal, and normal ECGs, respectively. Abnormal ECGs were also most associated with male sex, younger age (Ͻ20 years), and endurance sports (cycling, rowing/canoeing, and cross-country skiing). A subset of athletes (5% of the 1005) showed particularly abnormal or bizarre ECG patterns, but no evidence of structural cardiovascular abnormalities or an increase in cardiac dimensions. Conclusions-Most athletes (60%) in this large cohort had ECGs that were completely normal or showed only minor alterations. A variety of abnormal ECG patterns occurred in 40%; this was usually indicative of physiological cardiac remodeling. A small but important subgroup of athletes without cardiac morphological changes showed striking ECG abnormalities that suggested cardiovascular disease; however, these changes were likely an innocent consequence of long-term, intense athletic training and, therefore, another component of athlete heart syndrome. Such false-positive ECGs represent a potential limitation to routine ECG testing as part of preparticipation screening. (Circulation. 2000;102:278-284.)

Background-The clinical significance and long-term consequences of left ventricular (LV) hypertrophy associated with intensive athletic conditioning remain unresolved. Methods and Results-We prospectively evaluated 40 elite male athletes who had shown marked LV cavity enlargement of Ն60 mm, wall thickness of Ն13 mm, or both in a longitudinal fashion with serial echocardiograms, initially at peak training (age 24Ϯ4 years) and subsequently after a long-term deconditioning period (1 to 13 years; mean, 5.6Ϯ3.8).

Background: Sporting discipline is acknowledge to be an influential factor on the aspects of cardiac adaptation encountered in the athlete's heart syndrome. Little focus is carried to determine its influence on athletes of black ethnicity. Taking in consideration their unspecified training pattern, our study aimed at bringing out its impact on Cameroonian athletes. Methods: Was conducted a prospective cross sectional study, enrolling athletes trained at the NIYS of Yaounde, with their ages from 20 to 35 years and having at least a year duration at high intense practice. The disciplines included were Basketball, Football, Handball, Martial arts and Volleyball. Were excluded from the study all pregnant, breast feeding women and subjects with cardiovascular diseases. Ethical clearance and administrative authorization were obtained. Data was collected after an individual signed informed consent. Data compilation was done using CSPro version 6.0 and analysis done with SPSS version 20 and Microsoft Excel 2010. The Chi square test for comparison of proportions, the ANOVA test (analysis of variance) and student test for comparison of means. Statistical significance was set at p = 0.05. Results: 151 athletes were enrolled, 43.05% female and 56.95% male athletes for a male to female gender ratio of 1.3:1 and a mean age was 25.87±3.33 years. Anthropometric parameters differences in women showed statistical significance for body weight 75,5 ± 8,6 (p=0.04), body surface area 1,80 ± 0,13 (p=0.01) and BMI 28,1 ± 2,7 (p=0.04) in the martial arts discipline. No statistical significance was demonstrated in men for anthropometric parameters. The slowest heart rated differences were not significant for both genders between the different sporting disciplines. Abnormal repolarization pattern was statistically significant in men among the sporting disciplines (p= 0.04). No statistical significance was noted in women echocardiographic patterns. We noted a random distribution of highest values. LVEDD/BS (28.7 ± 3.5), LVESD/BS (17.7±3.0), IVC exp/BS (14.2±0.1) and IVC insp/BS (11.9±0.6) were highest in Basketball; for IVSd/BS (5.21±0.8) and LVEF (72.9±8.2) in Handball; for LVWTd/BS (4.5±1.4) and E/A ratio (2.2±0.1) in Football; for LAD/BS (22.1±2.4), LA area (20.7±4.1) and RVEDD/BS (10.5 ± 2.3) in Martial arts and AoD/BS (14.1±2.5) and TAPSE (16.7 ± 2.3) in Volleyball. We noted a random distribution of highest values for echocardiographic parameters in men. Highest recorded values for LVEDD/BS (27.4±2.5), LVESD/BS (17.2 ± 3.1), LVWTd/BS (4.7±1.0), LAD/BS (16.1±1.7), LA area (20.8±4.7), RVEDD/BS (12.7 ± 2.6), IVC exp/BS (12.7 ± 2.3), IVC insp/BS (7.7 ± 2.3) and AoD/BS (16.1±1.7) were in Football; for IVSd/BS (6.0±1.4), TAPSE (16.3 ± 2.8) and E/A ratio (2.2 ± 0.6) in Volleyball and LVEF (71.5 ± 7.3) in Handball. The only statistically significant value was for AoD/BS (p=0.006) in Football. Conclusion: More precisions on the Athletes heart syndrome are obtained from this study. The influence of unspecific training regime applied in our study...

In a large population of highly trained athletes, enlarged LA dimension > or = 40 mm was relatively common (20%), with the upper limits of 45 mm in women and 50 mm in men distinguishing physiologic cardiac remodeling ("athlete's heart") from pathologic cardiac conditions. Atrial fibrillation and other supraventricular tachyarrhythmias proved to be uncommon (prevalence < 1%) and similar to that in the general population, despite the frequency of LA enlargement. Left atrial remodeling in competitive athletes may be regarded as a physiologic adaptation to exercise conditioning, largely without adverse clinical consequences.

Markedly abnormal ECGs in young and apparently healthy athletes may represent the initial expression of underlying cardiomyopathies that may not be evident until many years later and that may ultimately be associated with adverse outcomes. Athletes with such ECG patterns merit continued clinical surveillance.