The early repolarization pattern: Echocardiographic characteristics in elite athletes
Corresponding Author
Wibke Reinhard
Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany
Correspondence
Wibke Reinhard, Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen, München, Germany.
Email: [email protected]
Search for more papers by this authorTeresa Trenkwalder
Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany
Search for more papers by this authorBernhard Haller
Institut für Medizinische Informatik, Statistik und Epidemiologie, Technical University Munich, Munich, Germany
Search for more papers by this authorChristine Meindl
Klinik und Poliklinik für Innere Medizin II, Universitätsklinikum Regensburg, Regensburg, Germany
Search for more papers by this authorJulia Schoenfeld
Department of Prevention, Rehabilitation and Sports Medicine, Technical University of Munich (TUM), Munich, Germany
Deutsches Zentrum für Herz- und Kreislauf-Forschung (DZHK) e.V. (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
Search for more papers by this authorBernhard M Kaess
Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany
Medizinische Klinik I, St. Josefs-Hospital, Wiesbaden, Germany
Search for more papers by this authorChristian Hengstenberg
Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany
Deutsches Zentrum für Herz- und Kreislauf-Forschung (DZHK) e.V. (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
Search for more papers by this authorHeribert Schunkert
Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany
Deutsches Zentrum für Herz- und Kreislauf-Forschung (DZHK) e.V. (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
Search for more papers by this authorAxel Pressler
Department of Prevention, Rehabilitation and Sports Medicine, Technical University of Munich (TUM), Munich, Germany
Search for more papers by this authorMartin Halle
Department of Prevention, Rehabilitation and Sports Medicine, Technical University of Munich (TUM), Munich, Germany
Deutsches Zentrum für Herz- und Kreislauf-Forschung (DZHK) e.V. (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
Search for more papers by this authorJohannes Scherr
Department of Prevention, Rehabilitation and Sports Medicine, Technical University of Munich (TUM), Munich, Germany
Deutsches Zentrum für Herz- und Kreislauf-Forschung (DZHK) e.V. (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
Search for more papers by this authorCorresponding Author
Wibke Reinhard
Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany
Correspondence
Wibke Reinhard, Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen, München, Germany.
Email: [email protected]
Search for more papers by this authorTeresa Trenkwalder
Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany
Search for more papers by this authorBernhard Haller
Institut für Medizinische Informatik, Statistik und Epidemiologie, Technical University Munich, Munich, Germany
Search for more papers by this authorChristine Meindl
Klinik und Poliklinik für Innere Medizin II, Universitätsklinikum Regensburg, Regensburg, Germany
Search for more papers by this authorJulia Schoenfeld
Department of Prevention, Rehabilitation and Sports Medicine, Technical University of Munich (TUM), Munich, Germany
Deutsches Zentrum für Herz- und Kreislauf-Forschung (DZHK) e.V. (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
Search for more papers by this authorBernhard M Kaess
Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany
Medizinische Klinik I, St. Josefs-Hospital, Wiesbaden, Germany
Search for more papers by this authorChristian Hengstenberg
Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany
Deutsches Zentrum für Herz- und Kreislauf-Forschung (DZHK) e.V. (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
Search for more papers by this authorHeribert Schunkert
Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany
Deutsches Zentrum für Herz- und Kreislauf-Forschung (DZHK) e.V. (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
Search for more papers by this authorAxel Pressler
Department of Prevention, Rehabilitation and Sports Medicine, Technical University of Munich (TUM), Munich, Germany
Search for more papers by this authorMartin Halle
Department of Prevention, Rehabilitation and Sports Medicine, Technical University of Munich (TUM), Munich, Germany
Deutsches Zentrum für Herz- und Kreislauf-Forschung (DZHK) e.V. (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
Search for more papers by this authorJohannes Scherr
Department of Prevention, Rehabilitation and Sports Medicine, Technical University of Munich (TUM), Munich, Germany
Deutsches Zentrum für Herz- und Kreislauf-Forschung (DZHK) e.V. (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
Search for more papers by this authorFunding information
Preparticipation screenings of athletes in the outpatient clinic are basically funded by the German Olympic Sports Federation (DOSB), but scientific analyses and research is not influenced by this funding in any kind of way. There are no relationships with industry.
Abstract
Background
The electrocardiographic early repolarization (ER) pattern is associated with idiopathic ventricular fibrillation and increased long-term cardiovascular mortality. Whether structural cardiac aberrations influence the phenotype is unclear. Since ER is particularly common in athletes, we evaluated its prevalence and investigated predisposing echocardiographic characteristics and cardiopulmonary exercise capacity in a cohort of elite athletes.
Methods
A total of 623 elite athletes (age 21 ± 5 years) were examined during annual preparticipation screening from 2006 until 2012 including electrocardiography, echocardiography, and exercise testing. ECGs were analyzed with focus on ER. All athletes participated in a clinical follow-up.
Results
The prevalence of ER was 17% (108/623). ER-positive athletes were predominantly male (71%, 77/108), showed a lower heart rate (57.1 ± 9.3 bpm versus 60.0 ± 11.2 bpm; p = 0.015) and a higher lean body mass compared to ER-negative participants (88.1% ± 5.6% versus 86.5% ± 6.3%; p = 0.015). Echocardiographic measurements and cardiopulmonary exercise capacity in male and female athletes with and without ER largely showed similar results. Only the notching ER subtype (n = 15) was associated with an increased left atrial diameter (OR 7.01, 95%CI 1.65–29.83; p = 0.008), a higher left ventricular mass (OR 1.02, 95%CI 1.00–1.03; p = 0.038) and larger relative heart volume (OR 1.01, 95%CI 1.00–1.01; p = 0.01). During a follow-up of 7.4 ± 1.5 years, no severe cardiovascular event occurred in the study sample.
Conclusions
In elite athletes presence of ER is not associated with distinct alterations in echocardiography and cardiopulmonary exercise. Athletes presenting with ER are rather male, lean with a low heart rate.
CONFLICT OF INTEREST
The authors declare that there is no conflict of interest.
Supporting Information
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