Ferrari Filipe, da Silveira Anderson D, Rossi Arthur P, Pedrotti Luana G, Dilda Guilherme D, Aleixo Haroldo C, Magalhães Flávia C O, Emed Luiz G M, Soares Luciano G, Cardoso Fernando B, Bassan Fernando, Guerra Felipe E F, Neto Aureliano I S, da Silva Henrique C, Mourão Luiz F R M, Júnior José N, Coimbra Frederico P L, Arruda Ivan Z, Teixeira Mateus F, de Lima Gabriel F I, Torres Valdir, Vieira Carla T F, Meira Diogo T, Barbosa Filipe C D, de Andrade Júnior Edílson F, Alô Rodrigo O B, Facio Marcelo R, Ritt Luiz E F, Braga Fabrício, Herdy Artur H, Froelicher Victor F, Stein Ricardo
Graduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Exercise Cardiology Research Group (CardioEx), Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
Heart. 2025 Jun 26;111(14):657-661. doi: 10.1136/heartjnl-2024-325484.
Early repolarisation (ER) is commonly observed during cardiovascular screenings of young athletes and can present with various morphologies. However, its prevalence and clinical significance in male Brazilian soccer players have not been characterised. This study aimed to compare the prevalence of different ER patterns and assess their potential clinical significance in this population.
In this multicentre observational study, we analysed ECG data from male Brazilian soccer players who underwent preparticipation evaluations at 83 professional clubs across Brazil's five geographic regions between February 2002 and August 2024. Our analysis included white, mixed-race and black athletes, as well as seven distinct ER morphologies. Poisson regression with robust variance was used to derive age-adjusted prevalence ratios for the different ER morphologies.
We included 6353 athletes (median (IQR) age: 19 (16-23) years; 2556 white, 2071 mixed-race and 1726 black individuals). ER patterns appeared in 2552 (40.2%) players. The most common ER morphologies with ST-segment elevation (STE) were a classic J-wave with ascending ST-segment (1275; 20.1%) and a discrete J-point with ascending ST-segment (735; 11.6%) in leads V4-V6. Without STE, the most frequent patterns were a slur on the downslope of the R-wave with ascending ST- segment (760; 12%), a slur with horizontal ST-segment (335; 5.3%) and a J-wave (199; 3.1%) in leads II, III and aVF. ER was more prevalent in black (48.1%) than in white (34.4%) or mixed-race (40.6%) athletes. Over a mean follow-up period of 4.4±3.1 years, no cases of sudden cardiac death were identified.
Our findings do not suggest that ER patterns observed in male Brazilian soccer players are associated with sudden cardiac death. Given the role of Brazil in exporting soccer talent, our results may help guide athlete assessments of ER worldwide.
早期复极（ER）在年轻运动员的心血管筛查中很常见，可呈现多种形态。然而，其在巴西男性足球运动员中的患病率及临床意义尚未明确。本研究旨在比较不同ER模式的患病率，并评估其在该人群中的潜在临床意义。
在这项多中心观察性研究中，我们分析了2002年2月至2024年8月期间在巴西五个地理区域的83个职业俱乐部进行参赛前评估的巴西男性足球运动员的心电图数据。我们的分析包括白人、混血和黑人运动员，以及七种不同的ER形态。采用具有稳健方差的泊松回归来得出不同ER形态的年龄调整患病率比。
我们纳入了6353名运动员（年龄中位数（四分位间距）：19（16 - 23）岁；白人2556名、混血2071名、黑人1726名）。2552名（40.2%）运动员出现了ER模式。ST段抬高（STE）最常见的ER形态是V4 - V6导联中ST段上升的经典J波（1275例；20.1%）和ST段上升的离散J点（735例；11.6%）。无STE时，最常见的模式是R波降支上有切迹且ST段上升（760例；12%）、ST段水平有切迹（335例；5.3%）以及II、III和aVF导联中有J波（199例；3.1%）。ER在黑人运动员（48.1%）中比在白人（34.4%）或混血（40.6%）运动员中更普遍。在平均4.4±3.1年的随访期内，未发现心源性猝死病例。
我们的研究结果并不表明在巴西男性足球运动员中观察到的ER模式与心源性猝死有关。鉴于巴西在输出足球人才方面的作用，我们的结果可能有助于指导全球范围内运动员的ER评估。
