Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy.
Health and Science Department, World Athletics, Monaco, Monaco.
Clin Cardiol. 2020 Aug;43(8):827-833. doi: 10.1002/clc.23365. Epub 2020 Apr 7.
The presence of T-wave inversion (TWI) at 12-lead electrocardiogram (ECG) in competitive athletes is one of the major diagnostic challenges for sports physicians and consulting cardiologists. Indeed, while the presence of TWI may be associated with some benign conditions and it may be occasionally seen in healthy athletes presenting signs of cardiac remodeling, it may also represent an early sign of an underlying, concealed structural heart disease or life-threatening arrhythmogenic cardiomyopathies, which may be responsible for exercise-related sudden cardiac death (SCD). The interpretation of TWI in athletes is complex and the inherent implications for the clinical practice represent a conundrum for physicians. Accordingly, the detection of TWI should be viewed as a potential red flag on the ECG of young and apparently healthy athletes and warrants further investigations because it may represent the initial expression of cardiomyopathies that may not be evident until many years later and that may ultimately be associated with adverse outcomes. The aim of this review is, therefore, to report an update of the literature on TWI in athletes, with a specific focus on the interpretation and management.
在 12 导联心电图（ECG）中出现 T 波倒置（TWI）是运动医生和咨询心脏病专家面临的主要诊断挑战之一。事实上，虽然 TWI 的存在可能与一些良性情况有关，并且在表现出心脏重构迹象的健康运动员中偶尔可见，但它也可能代表潜在的隐匿性结构性心脏病或危及生命的致心律失常性心肌病的早期迹象，这可能是导致与运动相关的心脏性猝死（SCD）的原因。运动员 TWI 的解释很复杂，其对临床实践的内在影响对医生来说是一个难题。因此，应将 TWI 的检测视为年轻且看似健康的运动员 ECG 上的潜在危险信号，并需要进一步检查，因为它可能代表心肌病的早期表现，这些表现可能在多年后才变得明显，并且最终可能与不良结局相关。因此，本综述的目的是报告有关运动员 TWI 的文献更新，重点关注解释和管理。
