Duyuler Serkan, Türker Duyuler Pınar, Batur Mustafa Kemal
Department of Cardiology, Acıbadem Ankara Hospital, Ankara, Turkey.
Department of Cardiology, Ankara Numune Education and Research Hospital, Ankara, Turkey.
Ann Noninvasive Electrocardiol. 2016 Nov;21(6):557-565. doi: 10.1111/anec.12365. Epub 2016 Mar 28.
Electrocardiography (ECG) is frequently used in preparticipation evaluation of competitive athletes. Repolarization heterogeneities on ECG is a well-known indicator for malignant ventricular arrhythmias and sudden cardiac death. We aimed to investigate the effect of iron and homocysteine levels on arrhythmogenic indicators, T peak-to-end (Tp-e) interval, and Tp-e/QT ratio in elite athletes.
A total of 72 players (48 football and 24 basketball) with a mean age of 25.4 ± 5.0 years were included to the analysis. Blood biochemistry, homocysteine level, and iron parameters (transferrin saturation and serum iron) were obtained by standard methods. Duration of QRS, QT interval, and Tp-e interval were measured manually on the precordial leads and Tp-e/QT ratio was calculated.
Baseline demographic and clinical characteristics of the study population were compared in two groups according to the median value of Tp-e/QT = 0.219. Both iron and transferrin saturations were higher in the above median group (P = 0.001 and P = 0.002, respectively), however, homocysteine levels were not statistically different among two groups (P = 0.405). In correlation analysis, both serum iron and transferrin saturation were significantly correlated with Tp-e interval (r = 0.368; P = 0.001 and r = 0.394; P = 0.00, respectively) and Tp-e/QT ratio (r = 0.357; P = 0.002 and r = 0.372; P = 0.001, respectively). Multiple stepwise regression analysis revealed that transferrin saturation was an independent predictor of Tp-e interval and Tp-e/QT ratio (β = 0.325; P = 0.002 and β = 0.372; P = 0.001, respectively).
This study showed an independent relationship between iron status and Tp-e interval and Tp-e/QT ratios of elite sport players which were also not correlated with serum homocysteine levels.
心电图(ECG)常用于竞技运动员的参赛前评估。心电图上的复极异质性是恶性室性心律失常和心源性猝死的一个众所周知的指标。我们旨在研究铁和同型半胱氨酸水平对精英运动员心律失常指标、T峰至末(Tp-e)间期和Tp-e/QT比值的影响。
共有72名平均年龄为25.4±5.0岁的运动员(48名足球运动员和24名篮球运动员)纳入分析。通过标准方法获取血液生化、同型半胱氨酸水平和铁参数(转铁蛋白饱和度和血清铁)。在胸前导联上手动测量QRS时限、QT间期和Tp-e间期,并计算Tp-e/QT比值。
根据Tp-e/QT的中位数0.219将研究人群的基线人口统计学和临床特征分为两组进行比较。上述中位数以上组的铁和转铁蛋白饱和度均较高(分别为P = 0.001和P = 0.002),然而,两组间同型半胱氨酸水平无统计学差异(P = 0.405)。在相关性分析中,血清铁和转铁蛋白饱和度均与Tp-e间期显著相关(分别为r = 0.368;P = 0.001和r = 0.394;P = 0.00)以及Tp-e/QT比值(分别为r = 0.357;P = 0.002和r = 0.372;P = 0.001)。多元逐步回归分析显示,转铁蛋白饱和度是Tp-e间期和Tp-e/QT比值的独立预测因子(分别为β = 0.325;P = 0.002和β = 0.372;P = 0.001)。
本研究表明精英运动员的铁状态与Tp-e间期和Tp-e/QT比值之间存在独立关系,且与血清同型半胱氨酸水平无关。