Hermelin Michael J, Prutkin Jordan M
Department of Internal Medicine, University of Washington, Seattle, WA, United States.
Department of Internal Medicine, University of Washington, Seattle, WA, United States; Division of Cardiology, University of Washington, Seattle, WA, United States.
J Electrocardiol. 2018 Jul-Aug;51(4):680-682. doi: 10.1016/j.jelectrocard.2018.05.004. Epub 2018 May 25.
There is debate over the use of the electrocardiogram (ECG) to screen athletes for disorders associated with sudden cardiac death, but if screening is completed, accurate ECG interpretation is important. Recently, there has been recognition of a normal black athlete repolarization pattern which includes J-point elevation, convex ST-segment elevation, and T-wave inversions in leads V1 to V4 occurring in 5-15% of black athletes. This pattern must be differentiated from T-wave inversions that are associated with hypertrophic cardiomyopathy or arrhythmogenic right ventricular cardiomyopathy. The combination of J-point elevation >1 mm and T-wave inversions confined to leads V1-V4 excludes cardiomyopathy. If T-wave inversions are present in the inferior or lateral leads or there is no J-point elevation, further evaluation for a cardiomyopathy is required. By recognizing this ECG pattern as a normal variant, unnecessary ancillary testing and restriction from sports can be avoided.
关于使用心电图（ECG）对运动员进行与心源性猝死相关疾病筛查存在争议，但如果要进行筛查，准确解读心电图很重要。最近，人们认识到一种正常的黑人运动员复极模式，包括J点抬高、ST段凸面抬高以及V1至V4导联出现T波倒置，5%-15%的黑人运动员存在这种情况。这种模式必须与肥厚型心肌病或致心律失常性右室心肌病相关的T波倒置相鉴别。J点抬高>1毫米且T波倒置仅限于V1-V4导联可排除心肌病。如果下壁或侧壁导联出现T波倒置或没有J点抬高，则需要进一步评估是否患有心肌病。通过将这种心电图模式识别为正常变异，可以避免不必要的辅助检查和运动限制。
