Institute of Sport Medicine and Science, Italy.
Cardiovascular Center Zurich, Switzerland.
Eur J Prev Cardiol. 2020 Sep;27(14):1542-1548. doi: 10.1177/2047487320914758. Epub 2020 Mar 30.
Recently, novel interest in low QRS voltages was prompted by the observation that low QRS voltages are present in arrhythmogenic cardiomyopathy patients, even before occurrence of symptoms/events.
The purpose of this study was to assess prevalence and clinical correlates of low QRS voltages in Olympic athletes, evaluated and followed-up within our cardiovascular screening programme.
Five hundred and sixteen athletes consecutively examined (2010-2011) were included in this study. A low QRS voltage was defined as amplitude of QRS <0.5 mV in limb and/or <1.0 mV in precordial leads. Cardiovascular evaluation included 12-lead and exercise electrocardiogram, echocardiography and, selectively, additional tests to confirm diagnosis. Athletes were followed-up for 5 ± 2 (1-9) years.
The majority of athletes (493; 96%) showed normal/increased R/S-wave voltages, but 23 (4%) had low QRS voltages. No differences were observed in low QRS voltage athletes compared to normal/increased QRS voltages for QRS duration, QTc and PR intervals, left ventricular cavity size and mass, or gender and sport participated. However, premature ventricular beats, occurred more frequently in low QRS voltages (39% vs 7%; < 0.001), with patterns suggesting origin from left or right free wall. No diseases or events were registered in low QRS voltage athletes over the follow-up.
In Olympic athletes, the prevalence of low QRS voltages was 4%. Athletes with low QRS voltages did not differ from other athletes according to sport participated in or cardiac dimensions. However, more frequently (39% vs 7%) they showed premature ventricular beats, originating from either the left or right free ventricular wall. Therefore, long-term follow-up with serial clinical evaluations is needed in low QRS voltage athletes, in order to definitely clarify the clinical significance.
最近，人们对低 QRS 电压产生了新的兴趣，因为观察到心律失常性心肌病患者在出现症状/事件之前就存在低 QRS 电压。
本研究旨在评估低 QRS 电压在我们心血管筛查计划中评估和随访的奥林匹克运动员中的患病率和临床相关性。
本研究纳入了 516 名连续接受检查的运动员（2010-2011 年）。低 QRS 电压定义为肢体 QRS 振幅<0.5 mV 和/或胸前导联<1.0 mV。心血管评估包括 12 导联和运动心电图、超声心动图，以及选择性地进行额外测试以确认诊断。运动员随访 5±2（1-9）年。
大多数运动员（493 名；96%）表现出正常/增高的 R/S 波电压，但 23 名（4%）存在低 QRS 电压。与正常/增高 QRS 电压相比，低 QRS 电压运动员的 QRS 持续时间、QTc 和 PR 间期、左心室腔大小和质量或性别和所参与的运动没有差异。然而，低 QRS 电压患者的室性早搏更为常见（39%比 7%；<0.001），且起源于左或右游离壁的模式提示。在随访期间，低 QRS 电压运动员未发生任何疾病或事件。
在奥林匹克运动员中，低 QRS 电压的患病率为 4%。根据所参与的运动或心脏尺寸，低 QRS 电压运动员与其他运动员没有差异。然而，他们更频繁地（39%比 7%）出现起源于左或右游离壁的室性早搏。因此，需要对低 QRS 电压运动员进行长期随访和连续临床评估，以明确其临床意义。
