Jongman Jesse K, Zaidi Abbas, Muggenthaler Martina, Sharma Sanjay
Department of Cardiology, Isala Clinics, Zwolle, the Netherlands Division of Cardiovascular Sciences, St George's University of London, Cranmer Terrace, London SW17 0RE, UK.
Division of Cardiovascular Sciences, St George's University of London, Cranmer Terrace, London SW17 0RE, UK.
Europace. 2015 Sep;17(9):1441-8. doi: 10.1093/europace/euv063. Epub 2015 Apr 1.
Regular physical exercise results in physiological cardiovascular changes. Athletes may demonstrate electrocardiographic changes that can also be seen in certain cardiomyopathies such as arrhythmogenic right-ventricular cardiomyopathy (ARVC). The aim of this study was to assess the prevalence of one such electrocardiographic characteristic, the abnormal signal-averaged ECG (SAECG), and to assess the correlation between SAECG parameters and echocardiographic parameters in athletes participating in sporting disciplines with combined strength and endurance components.
We evaluated 24 elite athletes and 27 amateur athletes participating in combined high dynamic and high static (HDHS) sports, using an ECG, SAECG, and a transthoracic echocardiogram. The SAECG was regarded as positive for late potentials if one out of three parameters was abnormal. Prolongation of the filtered QRS duration (fQRS) was present in all of the elite athletes, compared with 74.1% of the amateur athletes (P = 0.011). There was a low prevalence of abnormalities in the other two SAECG parameters [low-amplitude signal (LAS) duration and root-mean-square (RMS) voltage]. The percentage of elite athletes and amateur athletes with ≥2 abnormal SAECG parameters was 8.3 and 7.4% (P = 0.99), respectively. Most of the echocardiographic dimensions were significantly greater in the elite athlete group compared with the amateur athletes. There was a moderate positive correlation between the fQRS and right-ventricular dimensions.
The majority of elite and amateur athletes participating in HDHS sports reveal a prolonged fQRS duration on the SAECG, and according to the 2010 Task Force criteria for the diagnosis of ARVC, these athletes therefore demonstrate late potentials. The extent of fQRS prolongation is positively correlated with RV dimensions. Therefore SAECG findings should be interpreted with caution in endurance athletes.
定期进行体育锻炼会导致心血管系统发生生理变化。运动员可能会出现一些心电图改变，这些改变在某些心肌病中也可见，如致心律失常性右室心肌病（ARVC）。本研究的目的是评估一种这样的心电图特征——异常信号平均心电图（SAECG）的患病率，并评估参加具有力量和耐力综合成分的体育项目的运动员中SAECG参数与超声心动图参数之间的相关性。
我们对24名精英运动员和27名参加高动态和高静态（HDHS）综合运动项目的业余运动员进行了评估，使用了心电图、SAECG和经胸超声心动图。如果三个参数中有一个异常，则SAECG被视为晚期电位阳性。所有精英运动员均出现滤波QRS波时限（fQRS）延长，相比之下，74.1%的业余运动员出现fQRS延长（P = 0.011）。其他两个SAECG参数[低振幅信号（LAS）时限和均方根（RMS）电压]异常的患病率较低。SAECG参数≥2项异常的精英运动员和业余运动员的比例分别为8.3%和7.4%（P = 0.99）。与业余运动员相比，精英运动员组的大多数超声心动图测量值明显更大。fQRS与右心室尺寸之间存在中度正相关。
大多数参加HDHS运动项目的精英和业余运动员的SAECG显示fQRS时限延长，根据2010年ARVC诊断工作组标准，这些运动员因此表现出晚期电位。fQRS延长程度与右心室尺寸呈正相关。因此，对于耐力运动员，应谨慎解读SAECG结果。
