Abstract 15941: The Effects of Training and Detraining on T Wave Inversion in Athletes
Introduction: T wave inversion (TWI) is the electrical hallmark of primary cardiomyopathies which are substrates for sudden death in young athletes. Such repolarization anomalies can feature on the ECG of an apparently healthy athlete and pose major diagnostic dilemmas in sports cardiology. Athletes are reluctant to detrain during the season.
Hypothesis: This study hypothesized that detraining would affect TWI in athletes.
Methods: Between 2013-2014, 36 professional footballers demonstrated TWI at mid-season ECG screenings (trained period). They were followed up during the "off-season" after a period of detraining (6-8 weeks). TWI was defined as –0.1 mV or greater 2 or more contiguous leads: anterior leads-V2-V3/4; inferior-II,III,aVF; or lateral-beyond V4 +/-aVL.
Comparisons were drawn by 2 independent cardiologists, between trained and detrained ECGs. All players were also investigated for an underlying cardiomyopathy.
Results: *Athletes were male, aged 24.5+/-2.7 years.
*27 (75%) were Afro-Caribbean and 25% Caucasian (p=0.0141).
*TWI was most common in the anterior leads (n=20, 55%), followed by inferior (n=10, 28%) and lateral (n=6, 17%) as in the bar chart.
*No Caucasian player had TWI laterally.
*After detraining, 16 players demonstrated resolution of anterior TWI (80%, p=0.0293), 8 in inferior leads (80%, p=0.2353) and 4 in the lateral leads (67%, p=0.638) (Figures 1a & b).
*All players with abnormal TWI according to consensus guidelines were evaluated with no cardiomyopathy identified.
Conclusions: In athletes who detrained during the 'off-season', we observed resolution of TWI in the majority of athletes (both Afro-Caribbean and Caucasian) after a relatively brief period of detraining which may be a physiological phenomenon. This was statistically significant in the anterior leads.
However, TWI in the inferior and/or lateral leads should always raise the suspicion of an underlying cardiomyopathy, especially if persistent after detraining.
Author Disclosures: A. Malhotra: None. S. Varkey: None. H. Dhutia: None. M. Walker: None. R. Narain: None. A. Merghani: None. L. Millar: None. M. Papadakis: None. S. Sharma: None.
- © 2015 by American Heart Association, Inc.