Abstract 11178: Electrocardiographic Comparison of Healthy Young Men, Athletes and Patients with Hypertrophic Cardiomyopathy

Abstract

BACKGROUND: Standardized analysis and comparison of the ECGs of healthy young men, athletes and patients with hypertrophic cardiomyopathy (HCM) should lead to the development of criteria to optimize the recognition of those with HCM.

METHODS: We performed a retrospective study of 41,408 ECGs collected from 2004 to 2006 on male Swiss Army recruits, 1,117 ECGs gathered on Stanford University varsity athletes in 2007 and 2008 (both groups 18 to 21 years of age) and 265 patients with HCM from the Stanford Inherited CV Disease clinic (21 to 65 years of age). The ECGs were converted to a standard digital format and processed by specialized software appropriate for athletic screening. All of the ECGs were over read and any discrepancies between the program and the readers were resolved by an expert Electrocardiographer.

RESULTS: The prevalence of the following criteria used for diagnosing HCM were compared in the three populations along with the frequency when each abnormality occurred without any other abnormality in the HCM group (see table) Nine Stanford athletes had more than one abnormality (0.8%), 169 Swiss army recruits had 2 abnormalities (0.4%) and only 23 had 3 or more while 50% of the HCM patients had 2 or more abnormalities. T wave inversion was the only ECG abnormality in 10% of the HCM patients while 25% had a normal ECG.

CONCLUSIONS: Our data suggests that having more than one of these ECG abnormalities could be highly specific for identifying athletes with HCM while T wave inversion could be the most sensitive.