Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy.
Clinical Network of Sports and Exercise Medicine of the Veneto Region, Padova, Italy.
Scand J Med Sci Sports. 2022 Nov;32(11):1581-1591. doi: 10.1111/sms.14232. Epub 2022 Sep 15.
The early repolarization pattern (ERp) is an electrocardiographic finding previously associated with arrhythmic risk in adults. The purpose of this study is to evaluate the prevalence and characteristics of ERp in a group of adolescent athletes according to gender. Furthermore, potential associations with clinical, electrocardiographic, and echocardiographic parameters are explored.
In this cross-sectional study young athletes (age < 18 years) were consecutively enrolled during the annual pre-participation evaluation, undergoing also transthoracic echocardiography assessment from January 2015 to March 2020.
The prevalence of ERp was 27% in the whole population. Athletes with ERp were more frequently men practicing endurance sports. Women with ERp showed lower heart rate at rest, greater posterior, and relative ventricular wall thickness than those without ERp. Men with ERp presented higher systolic blood pressure at peak exercise, greater septal wall thickness, and indexed left ventricular mass than those without ERp. Both genders with ERp showed increased QRS voltage and narrower QRS duration. The ERp phenotype in men was more frequently notched with higher amplitude and ascending ST segment. Women's ERp presented more frequently a slurred morphology, especially in the inferior leads, and horizontal ST slope. No differences emerged in the occurrence of arrhythmias at rest and during maximal exercise test between groups, even considering higher risk phenotypes.
ERp is an ECG finding compatible with normal cardiac adaptations to training in young athletes. ERp demonstrated gender differences regarding phenotypes previously associated with increased cardiovascular risk, not showing any differences in arrhythmias during maximal exercise test.
早期复极（ERp）是一种心电图表现，先前与成年人的心律失常风险相关。本研究的目的是根据性别评估一组青少年运动员中 ERp 的发生率和特征。此外，还探讨了与临床、心电图和超声心动图参数的潜在关联。
在这项横断面研究中，年轻运动员（年龄<18 岁）在 2015 年 1 月至 2020 年 3 月期间的年度参赛前评估中连续入组，并同时接受经胸超声心动图评估。
整个研究人群中 ERp 的发生率为 27%。具有 ERp 的运动员更多是从事耐力运动的男性。具有 ERp 的女性在静息时心率较低，后、相对室壁厚度较大，而没有 ERp 的女性则较低。具有 ERp 的男性在运动峰值时的收缩压较高，室间隔壁厚度和左心室质量指数较大，而没有 ERp 的男性则较低。具有 ERp 的男女患者 QRS 波群电压增加，QRS 波群持续时间变窄。男性 ERp 表型更常出现高振幅和抬高的 ST 段切迹。女性 ERp 更常表现为模糊形态，尤其是在下导导联，以及水平 ST 段斜率。即使考虑到更高风险的表型，各组在静息和最大运动试验期间心律失常的发生率也没有差异。
ERp 是一种与年轻运动员训练引起的心脏适应性相符的心电图表现。ERp 在表型方面存在性别差异，与先前与心血管风险增加相关的表型不同，在最大运动试验期间没有出现心律失常。
