Outcomes in athletes with marked ECG repolarization abnormalities

The New England Journal of Medicine
Antonio PellicciaBarry J Maron

Abstract

Young, trained athletes may have abnormal 12-lead electrocardiograms (ECGs) without evidence of structural cardiac disease. Whether such ECG patterns represent the initial expression of underlying cardiac disease with potential long-term adverse consequences remains unresolved. We assessed long-term clinical outcomes in athletes with ECGs characterized by marked repolarization abnormalities. From a database of 12,550 trained athletes, we identified 81 with diffusely distributed and deeply inverted T waves (> or = 2 mm in at least three leads) who had no apparent cardiac disease and who had undergone serial clinical, ECG, and echocardiographic studies for a mean (+/-SD) of 9+/-7 years (range, 1 to 27). Comparisons were made with 229 matched control athletes with normal ECGs from the same database. Of the 81 athletes with abnormal ECGs, 5 (6%) ultimately proved to have cardiomyopathies, including one who died suddenly at the age of 24 years from clinically undetected arrhythmogenic right ventricular cardiomyopathy. Of the 80 surviving athletes, clinical and phenotypic features of hypertrophic cardiomyopathy developed in 3 after 12+/-5 years (at the ages of 27, 32, and 50 years), including 1 who had an aborted cardiac arrest. The ...Continue Reading

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