1 research outputs found
The importance of ST elevation in V2β4 ECG leads in athletes
Background Early repolarization in the anterior ECG leads (ERV2β4) 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: 15β20) and 120 leisure-time athletes (LTA; 71 men and 49 women, weekly training hours: 5β6) were investigated. The ERV2β4 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 (pβ<β0.01). Prevalence of the ERV2β4 sign was significantly higher in men than in women [pβ=β0.000, odds ratio (OR)β=β36.4] and in ETAs than in LTAs (pβ=β0.000). The highest ERV2β4 prevalence appeared in the most highly trained triathlonists and canoe and kayak paddlers (ORβ=β13.8 and 5.2, respectively). Within the ETA group, the post-exercise LAE, RAE, and RVcd changes developed more frequently in cases with than without ERV2β4 (LAE: men: pβ<β0.05, females: pβ<β0.005; RAE: men: pβ<β0.05, females: pβ<β0.005; RVcd: N.S.). These post-exercise appearing LAE, RAE, and RVcd are associated with the ERV2β4 sign (ORβ=β4.0, 3.7, and 3.8, respectively). Conclusions According to these results, ERV2β4 develops mainly in male ETAs due to long-lasting and repeated endurance training. The ERV2β4 sign indicates RVβs adaptation to maintain higher compensatory pulmonary pressure and flow during exercise but its danger regarding malignant arrhythmias is unclear