Abstract 18757: Sport-Specific Prevalence of Right Precordial T Wave Inversions in Caucasian Athletes and Associated Electrocardiographic Findings
Introduction: While right precordial T wave inversions (RPTWI) are associated with specific cardiomyopathic conditions including ARVC, they are common among trained athletes without underlying heart disease. RPTWI in athletes, particularly those that are not of Afro-Caribbean descent, remain poorly understood and represent a source of considerable clinical controversy. We therefore sought to examine the prevalence, training physiology specificity, and ECG correlates of RPTWI among asymptomatic Caucasian athletes.
Methods: Competitive collegiate Caucasian male endurance athletes (rowers, n=168) and strength-trained athletes (football players, n=162) underwent standard 12-lead ECG at the time of pre-participation screening. ECGs were analyzed for standard quantitative parameters and for the presence of RPTWI defined as TWI ≥2mm in ≥2 leads from V1 to V3.
Results: RPTWI were significantly more prevalent in endurance athletes (25%) than in strength-trained athletes (4%, p<0.001; Figure). Significant univariate predictors for the presence of RPTWI included sport type (endurance), lighter weight, a larger “more vertical” QRS axis, and incomplete RBBB. In a multivariate model that adjusted for sport type, incomplete RBBB (OR = 3.38, p=0.001) and QRS axis (OR = 1.019, p=0.03) remained significantly associated with RPTWI. RPTWI that extended beyond lead V2 were uncommon in both groups (1%).
Conclusions: Among competitive Caucasian athletes, RPTWI are significantly more common among endurance athletes and are associated with several specific benign training-related ECG findings. Future work is necessary to clarify underlying mechanisms of RPTWI including the relative contributions of ventricular depolarization axis and physiologic right ventricular remodeling.
Author Disclosures: M.M. Wasfy: None. J. DeLuca: None. R. Weiner: None. A.M. Hutter: None. F. Wang: None. B. Berkstresser: None. A.L. Baggish: None.
This research has received full or partial funding support from the American Heart Association.
- © 2014 by American Heart Association, Inc.