Abstract 10616: Assessing Electrocardiographic Screening in Elite High School Athletes with Comparison to Adolescents with Hypertrophic Cardiomyopathy
Background: Electrocardiography (ECG) in athletic screening has been studied widely. In trained athletes, ECG aberrations are common and often prompt evaluation for underlying cardiac pathology. We sought to compare ECG findings in a cohort of elite high school athletes to a cohort of adolescents with hypertrophic cardiomyopathy (HCM).
Methods: We prospectively performed standard 15-lead ECGs followed by echocardiography in 187 high school students (age 15.9 ± 1.5 yrs), including 147 elite nationally-competing high school athletes and 40 healthy non-athlete controls. ECG results were compared to baseline ECGs of a retrospective cohort of 53 adolescents diagnosed with non-syndromic HCM (age 14.1 ± 1.8 yrs). We assessed ECGs for published criteria of left or right ventricular hypertrophy (LVH or RVH) and for ST segment, T wave, or Q wave abnormalities.
Results: Overall, 28/147 (19%) elite athletes satisfied ECG criteria for RVH or LVH (or both), compared to 2/40 (5%) controls (p<0.05) and 33/53 (62%) adolescents with HCM (p<0.0001). Of 20 HCM patients not meeting LVH/RVH criteria, 10 (50%) had other ECG anomalies including Q wave, T wave, and ST segment abnormalities, while the remaining half had normal ECGs. None of the screened student athletes had an abnormal echocardiogram. There was significant overlap in ECG measurements between the three cohorts (Table 1). R and S wave deflections in lead V1 and presence of ST-segment, T wave, and Q wave abnormalities most successfully stratified the HCM cohort from the student cohort independent of athletic activity.
Conclusions: Truly elite athletes have a higher rate of ventricular hypertrophy per ECG criteria than what is reported in standard sports screening literature. There is overlap on ECG between adolescents with HCM and elite high school athletes. A combination of voltages in lead V1 associated with ST segment, T wave, and Q wave abnormalities may be useful as potential markers for HCM.
- Hypertrophic cardiomyopathy
- Pediatric cardiology
- Pediatric electrophysiology
- Health and fitness
- © 2011 by American Heart Association, Inc.