Abstract 9468: Spectrum of ST Amplitude: Athletes and an Ambulatory Clinical Population
INTRODUCTION: Despite the relationship of the ST segment to chest pain, channelopathies, and early repolarization, there is limited data describing ST amplitudes in apparently healthy populations and athletes.
HYPOTHESIS: We sought to better characterize the spectrum of ST amplitude with the hypothesis that there is a meaningful difference in ST levels between an ambulatory clinical population and healthy athletes.
METHODS: We performed a retrospective study of 5,085 computerized ECGs from February, 1997 to December, 1999 at the Veterans Affairs Palo Alto Health Care System, with 4,041 analyzed after exclusion of ECGs with pathological conditions that could cause ST elevation. Twelve-lead ECGs were also analyzed from all 1,117 Stanford University athletes undergoing annual pre-participation physical exams in 2007 and 2008. Using the PR interval as the isoelectric line and an amplitude criterion of >0.1mV, ST amplitudes were measured from the end of the QRS complex.
RESULTS: Of the clinical subjects, 87% were male, 13% African American (AA), and 87% Caucasian or other, with a mean age of 55 ± 14 years. Of the athletes, 55% were male, 14% African American, with a mean age of 19 ± 1.5 years. The precordial leads exhibited the largest median ST amplitudes and largest differences in comparison by gender, ethnicity, and group. Compared to females, males had greater median ST levels within both populations with a larger percentage of males with ST amplitudes >0.1mV (for V2: 28.3% versus 17.1%, p<0.0001). Compared to clinical subjects, athletes had greater median ST levels and a greater proportion had ST amplitudes >0.1mV (for V2: 53.0% versus 17.7%, p<0.0001). Compared to Caucasions and others, African Americans had more than twice the prevalence of ST elevation >0.1mV in V5 (8.1% versus 2.9%, p<0.001).
CONCLUSIONS: When assessing the clinical significance of ST elevation, the differences due to athletic status, gender, and ethnicity illustrated here must be considered.
- © 2012 by American Heart Association, Inc.