Dores Hélder, Malhotra Aneil, Sheikh Nabeel, Millar Lynne, Dhutia Harshil, Narain Rajay, Merghani Ahmed, Papadakis Michael, Sharma Sanjay
Hospital das Forças Armadas, Lisboa, Portugal; Hospital da Luz, Lisboa, Portugal; NOVA Medical School, Lisboa, Portugal.
Department of Cardiovascular Sciences, St. George's University of London, London, United Kingdom.
Rev Port Cardiol. 2016 Nov;35(11):593-600. doi: 10.1016/j.repc.2016.04.012. Epub 2016 Sep 29.
Athletes can exhibit abnormal electrocardiogram (ECG) phenotypes that require further evaluation prior to competition. These are apparently more prevalent in high-intensity endurance sports. The purpose of this study was to assess the association between ECG findings in athletes and intensity of sport and level of competition.
A cohort of 3423 competitive athletes had their ECGs assessed according to the Seattle criteria (SC). The presence of abnormal ECGs was correlated with: (1) intensity of sport (low/moderate vs. at least one high static or dynamic component); (2) competitive level (regional vs. national/international); (3) training volume (≤20 vs. >20 hours/week); (4) type of sport (high dynamic vs. high static component). The same endpoints were studied according to the 'Refined Criteria' (RC).
Abnormal ECGs according to the SC were present in 225 (6.6%) athletes, more frequently in those involved in high-intensity sports (8.0% vs. 5.4%; p=0.002), particularly in dynamic sports, and competing at national/international level (7.1% vs. 4.9%; p=0.028). Training volume was not significantly associated with abnormal ECGs. By multivariate analysis, high-intensity sport (OR 1.55, 1.18-2.03; p=0.002) and national/international level (OR 1.50, 95% CI 1.04-2.14; p=0.027) were independent predictors of abnormal ECGs, and these variables, when combined, doubled the prevalence of this finding. According to the RC, abnormal ECGs decreased to 103 (3.0%), but were also more frequent in high-intensity sports (4.2% vs. 2.0%; p<0.001).
There is a positive correlation between higher intensity of sports and increased prevalence of ECG abnormalities. This relationship persists with the use of more restrictive criteria for ECG interpretation, although the number of abnormal ECGs is lower.
运动员可能会出现异常心电图（ECG）表现型，在比赛前需要进一步评估。这些情况在高强度耐力运动中显然更为普遍。本研究的目的是评估运动员心电图检查结果与运动强度和比赛水平之间的关联。
对3423名竞技运动员的心电图按照西雅图标准（SC）进行评估。异常心电图的出现与以下因素相关：（1）运动强度（低/中等强度与至少有一个高静态或动态成分）；（2）比赛水平（地区性与全国性/国际性）；（3）训练量（≤20小时/周与>20小时/周）；（4）运动类型（高动态成分与高静态成分）。根据“细化标准”（RC）对相同的终点进行研究。
根据SC标准，225名（6.6%）运动员存在异常心电图，在参与高强度运动的运动员中更为常见（8.0%对5.4%；p = 0.002），尤其是在动态运动中，以及参加全国性/国际性比赛的运动员中（7.1%对4.9%；p = 0.028）。训练量与异常心电图无显著关联。通过多因素分析，高强度运动（比值比1.55，95%可信区间1.18 - 2.03；p = 0.002）和全国性/国际性比赛水平（比值比1.50，95%可信区间1.04 - 2.14；p = 0.027）是异常心电图的独立预测因素，并且这些变量联合起来时，这一发现的患病率翻倍。根据RC标准，异常心电图减少至103例（3.0%），但在高强度运动中也更为常见（4.2%对2.0%；p < 0.001）。
运动强度越高与心电图异常患病率增加之间存在正相关。尽管异常心电图的数量较少，但在使用更严格的心电图解读标准时，这种关系仍然存在。
