Prevalence of abnormal and borderline electrocardiogram changes in 13, 079 Chinese amateur marathon runners

Abstract

Background The 12-lead electrocardiogram (ECG) has been adopted as an important component of preparticipation cardiovascular screening. However, there are still controversies in the screening and few studies with a large sample size have reported the results of ECGs of marathon runners. Therefore, the purpose of this study was to assess the prevalence of normal, borderline, and abnormal ECG changes in marathon runners. Methods The 12-lead ECG data of 13,079 amateur marathon runners between the ages of 18 and 35 years were included for analysis. The prevalence of ECG abnormalities among different gender groups was compared with chi-square tests. Results In terms of training-related changes, sinus bradycardia, sinus arrhythmia, and left ventricular high voltage were found in approximately 15, 5, and 3.28% of the participants, respectively. The incidence of right axis deviation in the marathon runners was 1.78%, which was slightly higher than the incidence of left axis deviation (0.88%). No more than 0.1% of the amateur marathon runners exhibited ST-segment depression, T wave inversion (TWI), premature ventricular contraction, pathologic Q waves, and prolonged QT interval. Conclusions Training-related ECG changes, including sinus bradycardia, sinus arrhythmia, and left ventricular high voltage, were common in amateur marathon runners. Most abnormal ECG changes, including ST-segment depression, TWI, premature ventricular contraction, pathologic Q waves, and prolonged QT interval, were infrequently found in amateur marathon runners. The data also suggested Chinese amateur marathon runners may have a relatively lower prevalence of ECG abnormalities than black and white runners.

Evaluation of the electrocardiogram RV5/V6 criteria in the diagnosis of left ventricular hypertrophy in marathon runners

“…Lasocka and coworkers 15 compared the ECG values before and after a race in amateur marathon runners and found that male runners exhibited higher exercise‐induced ECG changes than female runners. Physicians should explain the various ECG abnormalities in these athletes, including training‐related ECG changes that are common in marathon runners, such as sinus bradycardia, sinus arrhythmia, and LVH 16 …”

“…Physicians should explain the various ECG abnormalities in these athletes, including training-related ECG changes that are common in marathon runners, such as sinus bradycardia, sinus arrhythmia, and LVH. 16 The 12-lead ECG is the most economical and convenient diagnostic method for LVH in clinical settings, typically detecting LVH through changes in the electrical voltage of myocardial activity. In this study, the sequence of ventricular activation in the LVH group was the same as that in the control group.…”

“…Physicians should explain the various ECG abnormalities in these athletes, including training‐related ECG changes that are common in marathon runners, such as sinus bradycardia, sinus arrhythmia, and LVH. 16 …”

Hippocampal Subfield Volumes in Amateur Marathon Runners

“…This trend might in part reflect the increasing awareness among the general population that PE provides health benefit and reduces all-cause mortality ( 3 ). Compared with the few professional athletes, amateur marathon runners (AMR) are large in number, and their goals are primarily to improve their physical fitness, enrich their leisure life, maintain emotional well-being, or challenge themselves ( 4 , 5 ). Several studies have reported changes of cardiac and renal function ( 6 ), electrocardiography ( 7 ), and iron metabolism ( 8 ) in AMR.…”