Document Detail

The athlete's heart: remodeling, electrocardiogram and preparticipation screening.
MedLine Citation:
PMID:  11895574     Owner:  NLM     Status:  MEDLINE    
Highly trained athletes show morphologic cardiac changes (ie, athlete's heart) that are the consequence of several determinants, including type of sport, gender, and, possibly, inherited genetic factors. The extent of physiologic cardiac remodeling may occasionally be substantial in highly trained athletes and may raise a differential diagnosis with structural cardiac disease, such as cardiomyopathies. In addition, athletes demonstrate a spectrum of alterations in the 12-lead electrocardiogram (ECG) pattern, including marked increase in precordial R-wave or S-wave voltages, ST segment or T-wave changes, and deep Q waves suggestive of left ventricular hypertrophy, that may raise the possibility of pathologic heart condition, but have also been viewed as a consequence of the cardiac morphologic remodeling induced by athletic conditioning. To evaluate the clinical significance of these abnormal ECGs, the authors compared ECG patterns to cardiac morphology and function (assessed by two-dimensional echocardiography in individual athlete) in a large population of 1005 elite athletes engaged in a variety of sporting disciplines. Forty percent of the athletes had abnormal ECGs, and a subgroup of about 15% showed distinctly abnormal and often bizarre patterns highly suggestive of cardiomyopathies, such as hypertrophic cardiomyopathy, in the absence of pathologic cardiac changes. Such alterations are likely the consequence of athletic conditioning itself and represent another potential component of athlete's heart syndrome. However, such false-positive ECGs represent a potential limitation to the efficacy of routine ECG testing in the preparticipation cardiovascular screening of large athletic populations.
Antonio Pelliccia; Fernando M Di Paolo; Barry J Maron
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cardiology in review     Volume:  10     ISSN:  1061-5377     ISO Abbreviation:  Cardiol Rev     Publication Date:    2002 Mar-Apr
Date Detail:
Created Date:  2002-03-15     Completed Date:  2002-05-20     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9304686     Medline TA:  Cardiol Rev     Country:  United States    
Other Details:
Languages:  eng     Pagination:  85-90     Citation Subset:  IM    
Institute of Sports Science, Italian National Olympic Committee, Rome, Italy.
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MeSH Terms
Cardiomegaly / physiopathology
Cardiomyopathies / diagnosis
Death, Sudden, Cardiac / prevention & control
Diagnosis, Differential
Mass Screening / standards
Sex Factors
Sports / physiology*
Ventricular Remodeling / physiology*

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