非洲青少年运动员心脏：心电图和超声心动图研究。
The athlete's heart in adolescent Africans: an electrocardiographic and echocardiographic study.
机构信息
Institute of Sport Medicine and Science, CONI, Rome, Italy.
出版信息
J Am Coll Cardiol. 2012 Mar 13;59(11):1029-36. doi: 10.1016/j.jacc.2011.12.008.
OBJECTIVES
The goal of this study was to define electrocardiographic (ECG) and echocardiographic characteristics of adolescent African athletes.
BACKGROUND
Recent observations in African athletes reported large prevalence of left ventricular (LV) hypertrophy and ECG abnormalities. No data, so far, exist for adolescent Africans, which comprise a growing proportion of competitive/professional athletes.
METHODS
The study included 154 soccer players participating at the 8th African Under-17 Championship of 2009, representing Algeria, Burkina Faso, Cameroon, Gambia, Guinea, Malawi, Nigeria, and Zimbabwe. For comparison, 62 Italian players with similar ages, sport achievements, and training schedules were included.
RESULTS
African athletes showed higher R5/S1-wave voltages than Caucasian athletes (48.6 ± 12.1 mm vs. 34.1 ± 8.9 mm; p < 0.01), larger prevalence of ECG LV hypertrophy (89% vs. 42%; p < 0.001), ST-segment elevation (91% vs. 56%; p < 0.001), and deeply inverted, or diffusely flat/biphasic, T waves (14% vs. 3% [p < 0.05] and 25% vs. 8% [p < 0.008], respectively). LV wall thicknesses were increased in Africans by 5% compared with Caucasians, and exceeded normal limits (≥13 mm) in 4 Africans but in no Caucasians. No athlete showed evidence of cardiomyopathies (i.e., hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy). On individual analysis, Algerians showed lower R/S-wave voltages compared with other African athletes. Increased wall thickness (≥13 mm) was observed only in sub-Saharian athletes (from Burkina Faso, Cameroon, and Niger).
CONCLUSIONS
African athletes displayed large proportion of ECG abnormalities, including a striking increase in R/S-wave voltage, ST-segment elevation, and deeply inverted or diffusely flat T waves by adolescence. LV remodeling in African athletes was characterized by a disproportionate wall thickening than in Caucasians but similar cavity size. Finally, distinctive peculiarities existed in African athletes according to the country (and ethnic) origin.
目的
本研究旨在确定青少年非洲运动员的心电图（ECG）和超声心动图特征。
背景
最近在非洲运动员中观察到左心室（LV）肥大和 ECG 异常的高患病率。到目前为止，还没有关于青少年非洲人的数据，而青少年非洲人在竞技/职业运动员中所占比例越来越大。
方法
本研究纳入了 2009 年第八届非洲 17 岁以下锦标赛的 154 名足球运动员，他们分别来自阿尔及利亚、布基纳法索、喀麦隆、冈比亚、几内亚、马拉维、尼日利亚和津巴布韦。为了进行比较，还纳入了 62 名年龄、运动成绩和训练计划相似的意大利运动员。
结果
非洲运动员的 R5/S1 波电压高于白种人运动员（48.6 ± 12.1 mm 比 34.1 ± 8.9 mm；p < 0.01），心电图 LV 肥大的患病率更高（89%比 42%；p < 0.001），ST 段抬高（91%比 56%；p < 0.001），以及深倒置或弥漫平坦/双向 T 波（14%比 3%[p < 0.05]和 25%比 8%[p < 0.008]）。与白种人相比，非洲人的 LV 壁厚度增加了 5%，并且有 4 名非洲人但没有 1 名白种人超过正常范围（≥13 mm）。没有运动员表现出心肌病（即肥厚型心肌病、致心律失常性右室心肌病）的证据。在个体分析中，阿尔及利亚运动员的 R/S 波电压低于其他非洲运动员。仅在撒哈拉以南非洲运动员（来自布基纳法索、喀麦隆和尼日尔）中观察到壁厚度增加（≥13 mm）。
结论
非洲运动员在青春期表现出较大比例的 ECG 异常，包括 R/S 波电压、ST 段抬高和深倒置或弥漫平坦 T 波的显著增加。与白种人相比，非洲运动员的 LV 重构表现为不成比例的壁增厚，但腔室大小相似。最后，根据国家（和种族）起源，非洲运动员存在独特的特点。
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