Kaleta Anna M, Lewicka Ewa, Dąbrowska-Kugacka Alicja, Lewicka-Potocka Zuzanna, Wabich Elżbieta, Szerszyńska Anna, Dyda Julia, Sobolewski Jakub, Koenner Jakub, Raczak Grzegorz
Department of Cardiology and Electrotherapy, Medical University of Gdańsk, Poland.
Students' Cardiology Scientific Association, Department of Cardiology, Medical University of Gdańsk, Poland.
Adv Clin Exp Med. 2018 Aug;27(8):1091-1098. doi: 10.17219/acem/73700.
Sports activity has become extremely popular among amateurs. Electrocardiography is a useful tool in screening for cardiac pathologies in athletes; however, there is little data on electrocardiographic abnormalities in the group of amateur athletes.
The aim of this study was to analyze the abnormalities in resting and exercise electrocardiograms (ECGs) in a group of amateur athletes, and try to determine whether the criteria applied for the general population or for athletes' ECGs should be implemented in this group.
In 40 amateur male marathon runners, 3 consecutive 12-lead ECGs were performed: 2-3 weeks before (stage 1), just after the run (stage 2) and 2-3 weeks after the marathon (stage 3). Resting (stage 1) and exercise (stage 2) ECGs were analyzed following the refined criteria for the assessment of athlete's ECG (changes classified as training-related, borderline or training-unrelated).
In resting ECGs, at least 1 abnormality was found in 92.5% of the subjects and the most common was sinus bradycardia (62.5%). In post-exercise ECGs, at least 1 abnormality was present in 77.5% of the subjects and the most common was right atrium enlargement (RAE) (42.5%). Training-related ECG variants were more frequent at rest (82.5% vs 42.5%; p = 0.0008), while borderline variants - after the run (22.5% vs 57.5%; p = 0.0004). Training-unrelated abnormalities were found in 15% and 10% of the subjects, respectively (p-value - nonsignificant), and the most common was T-wave inversion.
Even if the refined criteria rather than the criteria used for normal sedentary population were applied, the vast majority of amateur runners showed at least 1 abnormality in resting ECGs, which were mainly training-related variants. However, at rest, in 15% of the subjects, pathologic training-unrelated abnormalities were found. The most frequent post-exercise abnormality was right atrial enlargement. General electrocardiographic screening in amateur athletes should be taken into consideration.
体育活动在业余爱好者中极为流行。心电图是筛查运动员心脏病变的有用工具；然而，关于业余运动员群体中心电图异常的数据很少。
本研究的目的是分析一组业余运动员静息和运动心电图（ECG）的异常情况，并试图确定该群体应采用适用于普通人群还是运动员心电图的标准。
对40名业余男性马拉松运动员进行了连续3次12导联心电图检查：马拉松赛前2 - 3周（阶段1）、赛后即刻（阶段2）和赛后2 - 3周（阶段3）。根据评估运动员心电图的细化标准（将变化分为与训练相关、临界或与训练无关）分析静息（阶段1）和运动（阶段2）心电图。
在静息心电图中，92.5%的受试者至少发现1项异常，最常见的是窦性心动过缓（62.5%）。在运动后心电图中，77.5%的受试者至少存在1项异常，最常见的是右心房扩大（RAE）（42.5%）。与训练相关的心电图变异在静息时更常见（82.5%对42.5%；p = 0.0008），而临界变异在运动后更常见（22.5%对57.5%；p = 0.0004）。分别在15%和10%的受试者中发现了与训练无关的异常（p值无统计学意义），最常见的是T波倒置。
即使采用的是细化标准而非用于正常久坐人群的标准，绝大多数业余跑步者在静息心电图中至少有1项异常，主要是与训练相关的变异。然而，在静息状态下，15%的受试者发现了与训练无关的病理性异常。运动后最常见的异常是右心房扩大。应考虑对业余运动员进行常规心电图筛查。
