Berte Benjamin, Duytschaever Mattias, Elices Juliana, Kataria Vikas, Timmers Liesbeth, Van Heuverswyn Frédéric, Stroobandt Roland, De Neve Jan, Watteyne Karel, Vandensteen Elke, Vandekerckhove Yves, Tavernier Rene
Department of Cardiology, Sint-Jan Hospital Bruges, Ruddershove 10, 8000 Bruges, Belgium.
Department of Cardiology, Sint-Jan Hospital Bruges, Ruddershove 10, 8000 Bruges, Belgium Heart Center, Ghent University Hospital, Ghent, Belgium.
Europace. 2015 Sep;17(9):1435-40. doi: 10.1093/europace/euu385. Epub 2015 Feb 5.
To assess in young athletes (i) the variability in the percentage of abnormal electrocardiograms (ECGs) using different criteria and (ii) the variability in ECG interpretation among cardiologists and sport physicians.
Electrocardiograms of 138 athletes were categorized by seven cardiologists according to the original European Society of Cardiology (ESC) criteria by Corrado (C), subsequently modified by Uberoi (U), Marek (M), and the Seattle criteria (S); seven sports physicians only used S criteria. The percentage of abnormal ECGs for each physician was calculated and the percentage of complete agreement was assessed. For cardiologists, the median percentage of abnormal ECGs was 14% [interquartile range (IQR) 12.5-20%] for C, 11% (IQR 9.5-12.5%) for U [not significant (NS) compared with C], 11% (IQR 10-13%) for M (NS compared with C), and 7% (IQR 5-8%) for S (P < 0.005 compared with C); complete agreement in interpretation was 64.5% for C, 76% for U (P < 0.05 compared with C), 74% for M (NS compared with C), and 84% for S (P < 0.0005 compared with C). Sport physicians classified a median of 7% (IQR 7-11%) of ECGs as abnormal by S (P = NS compared with cardiologists using S); complete agreement was 72% (P < 0.05 compared with cardiologists using S).
Seattle criteria reduced the number of abnormal ECGs in athletes and increased agreement in classification. However, variability in ECG interpretation by cardiologists and sport physicians remains high and is a limitation for ECG-based screening programs.
评估年轻运动员中（i）使用不同标准时异常心电图（ECG）百分比的变异性，以及（ii）心脏病专家和运动医学医生之间心电图解读的变异性。
138名运动员的心电图由7位心脏病专家根据欧洲心脏病学会（ESC）最初的Corrado标准（C）进行分类，随后由Uberoi（U）、Marek（M）修改，并根据西雅图标准（S）分类；7位运动医学医生仅使用S标准。计算每位医生的异常心电图百分比，并评估完全一致的百分比。对于心脏病专家，C标准下异常心电图的中位数百分比为14%[四分位间距（IQR）12.5 - 20%]，U标准下为11%（IQR 9.5 - 12.5%）[与C标准相比无显著差异（NS）]，M标准下为11%（IQR 10 - 13%）（与C标准相比NS），S标准下为7%（IQR 5 - 8%）（与C标准相比P < 0.005）；解读的完全一致率C标准为64.5%，U标准为76%（与C标准相比P < 0.05），M标准为74%（与C标准相比NS），S标准为84%（与C标准相比P < 0.0005）。运动医学医生根据S标准将心电图异常的中位数分类为7%（IQR 7 - 11%）（与使用S标准的心脏病专家相比P = NS）；完全一致率为72%（与使用S标准的心脏病专家相比P < 0.05）。
西雅图标准减少了运动员异常心电图的数量，并提高了分类的一致性。然而，心脏病专家和运动医学医生之间心电图解读的变异性仍然很高，这是基于心电图的筛查项目的一个限制因素。
