Ethnic differences in normal electrocardiographic findings in elite brazilian football players: b-pro foot ECG pilot study

Abstract

Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): CNPq, CAPES, FIPE-HCPA. Introduction The 12-lead electrocardiogram (ECG-12) is a useful tool in the assessment of athletes. The prevalence of normal electrocardiographic findings in elite Brazilian football players (EBFP) of different ethnicities is not well described. Purpose To compare the prevalence of normal ECG-12 findings in Caucasian, Mixed-race (MR), and Afro-Brazilian (AB) EBFP. Methods A multicenter cross-sectional descriptive study was conducted with exams performed on EBFP as a pre-participation assessment from February 18, 2002, through October 20, 2022. Results 4,363 EBFP from 51 professional clubs (from all five regions of Brazil; 15 states, and 21 cities), aged 15-35 years (median: 19 years; IQR: 16-23) were evaluated. 2,027 were Caucasians, 1,324 were MRs, and 1,012 were ABs. In general, we recorded 4,155 ECG-12 with normal variations (95.2%). Positive Sokolow-Lyon criteria for left ventricular hypertrophy was more prevalent in ABs (41.8%) than in Caucasians (33.4%), or MRs (32.7%). The prevalence of early repolarization in ABs (41.5%) was higher than in Caucasians (34.6%), or MRs (35.5%). The PR interval was longer in ABs (157.1 ms) than in Caucasians (151.4 ms), or MRs (153.3 ms), and the first-degree atrioventricular block was more frequent in ABs compared to MRs (4.2% vs. 2.3%, respectively). On the other hand, Caucasians had a higher prevalence of incomplete right bundle branch block (14.2%) than MRs (11.2%), or ABs (9.7%). In our sample, only three EBFP showed second-degree atrioventricular block Mobitz type I (0.07%; one Caucasian and two AB athletes). Conclusions This is the first large study to compare the prevalence of ECG-12 findings in EBFP from different ethnic groups. Those of AB origin have a significantly higher prevalence of ECG-12 findings compatible with the athlete's heart than Caucasians and MRs.