The importance of ST elevation in V 2-4 ECG leads in athletes.

Autor: Major Z; Institute of Physical Education and Sport Sciences, University of Nyíregyháza, Nyíregyháza, Hungary., Kirschner R; Department of Cardiology, Flór Ferenc Hospital of Pest County, Kistarcsa, Hungary., Medvegy N; Department of Marketing, KRKA Hungary Ltd., Budapest, Hungary., Kiss K; Department of Cardiology, Flór Ferenc Hospital of Pest County, Kistarcsa, Hungary., Török GM; Department of Cardiology, Flór Ferenc Hospital of Pest County, Kistarcsa, Hungary., Pavlik G; Department of Health Sciences and Sports Medicine, University of Physical Education, Budapest, Hungary., Simonyi G; Metabolic Center, St. Imre University Teaching Hospital, Budapest, Hungary., Komka Z; The Heart and Vascular Center, Semmelweis University, Budapest, Hungary., Medvegy M; Department of Cardiology, Flór Ferenc Hospital of Pest County, Kistarcsa, Hungary.
Jazyk: angličtina
Zdroj: Physiology international [Physiol Int] 2019 Dec 01; Vol. 106 (4), pp. 368-378. Date of Electronic Publication: 2019 Dec 18.
Abstrakt: Background: Early repolarization in the anterior ECG leads (ERV 2-4 ) is considered to be a sign of right ventricular (RV) remodeling, but its etiology and importance are unclear.
Methods: A total of 243 top-level endurance-trained athletes (ETA; 183 men and 60 women, weekly training hours: 15-20) and 120 leisure-time athletes (LTA; 71 men and 49 women, weekly training hours: 5-6) were investigated. The ERV 2-4 sign was evaluated concerning type of sport, gender, transthoracic echocardiographic parameters, and ECG changes, which can indicate elevated RV systolic pressure [left atrium enlargement (LAE), right atrium enlargement (RAE), RV conduction defect (RVcd)].
Results: Stroke volume and left ventricular mass were higher in ETAs vs. LTAs in both genders ( p  < 0.01). Prevalence of the ERV 2-4 sign was significantly higher in men than in women [ p  = 0.000, odds ratio (OR) = 36.4] and in ETAs than in LTAs ( p  = 0.000). The highest ERV 2-4 prevalence appeared in the most highly trained triathlonists and canoe and kayak paddlers (OR = 13.8 and 5.2, respectively). Within the ETA group, the post-exercise LAE, RAE, and RVcd changes developed more frequently in cases with than without ERV 2-4 (LAE: men: p  < 0.05, females: p  < 0.005; RAE: men: p  < 0.05, females: p  < 0.005; RVcd: N.S.). These post-exercise appearing LAE, RAE, and RVcd are associated with the ERV 2-4 sign (OR = 4.0, 3.7, and 3.8, respectively).
Conclusions: According to these results, ERV 2-4 develops mainly in male ETAs due to long-lasting and repeated endurance training. The ERV 2-4 sign indicates RV's adaptation to maintain higher compensatory pulmonary pressure and flow during exercise but its danger regarding malignant arrhythmias is unclear.
Databáze: MEDLINE
Externí odkaz: