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Prevalence and clinical significance of isolated low QRS voltages in young athletes( )
AIMS: Low QRS voltages (peak to peak <0.5 mV) in limb leads (LQRSV) on the athlete’s electrocardiogram (ECG) may reflect an underlying cardiomyopathy, mostly arrhythmogenic cardiomyopathy (ACM) or non-ischaemic left ventricular scar (NILVS). We studied the prevalence and clinical meaning of isola...
Autores principales: | , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9559913/ https://www.ncbi.nlm.nih.gov/pubmed/35243505 http://dx.doi.org/10.1093/europace/euab330 |
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author | Zorzi, Alessandro Bettella, Natascia Tatangelo, Mario Del Monte, Alvise Vessella, Teresina Poscolieri, Barbara Crescenzi, Cinzia Pegorin, Davide D’Ascenzi, Flavio Pescatore, Valentina Giada, Franco Sarto, Patrizio Calò, Leonardo Schiavon, Maurizio Gregori, Dario Hadley, David M Drezner, Jonathan A Pelliccia, Antonio Corrado, Domenico |
author_facet | Zorzi, Alessandro Bettella, Natascia Tatangelo, Mario Del Monte, Alvise Vessella, Teresina Poscolieri, Barbara Crescenzi, Cinzia Pegorin, Davide D’Ascenzi, Flavio Pescatore, Valentina Giada, Franco Sarto, Patrizio Calò, Leonardo Schiavon, Maurizio Gregori, Dario Hadley, David M Drezner, Jonathan A Pelliccia, Antonio Corrado, Domenico |
author_sort | Zorzi, Alessandro |
collection | PubMed |
description | AIMS: Low QRS voltages (peak to peak <0.5 mV) in limb leads (LQRSV) on the athlete’s electrocardiogram (ECG) may reflect an underlying cardiomyopathy, mostly arrhythmogenic cardiomyopathy (ACM) or non-ischaemic left ventricular scar (NILVS). We studied the prevalence and clinical meaning of isolated LQRSV in a large cohort of competitive athletes. METHODS AND RESULTS: The index group included 2229 Italian competitive athletes [median age 18 years (16–25), 67% males, 97% Caucasian] without major ECG abnormalities at pre-participation screening. Three control groups included Black athletes (N = 1115), general population (N = 1115), and patients with ACM or NILVS (N = 58). Echocardiogram was performed in all athletes with isolated LQRSV and cardiac magnetic resonance (CMR) in those with ventricular arrhythmias or echocardiographic abnormalities. The isolated LQRSV pattern was found in 1.1% index athletes and was associated with increasing age (median age 28 vs. 18 years; P < 0.001), elite status (71% vs. 34%; P < 0.001), body surface area, and body mass index but not with sex, type of sport, and echocardiographic left ventricular mass. The prevalence of isolated LQRSV was 0.2% in Black athletes and 0.3% in young individuals from the general population. Cardiomyopathy patients had a significantly greater prevalence of isolated LQRSV (12%) than index athletes, Black athletes, and general population. Five index athletes with isolated LQSRV and exercise-induced ventricular arrhythmias underwent CMR showing biventricular ACM in 1 and idiopathic NILVS in 1. CONCLUSIONS: Unlike cardiomyopathy patients, the ECG pattern of isolated LQRSV was rarely observed in athletes. This ECG sign should prompt clinical work-up for exclusion of an underlying cardiomyopathy. |
format | Online Article Text |
id | pubmed-9559913 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-95599132022-10-18 Prevalence and clinical significance of isolated low QRS voltages in young athletes( ) Zorzi, Alessandro Bettella, Natascia Tatangelo, Mario Del Monte, Alvise Vessella, Teresina Poscolieri, Barbara Crescenzi, Cinzia Pegorin, Davide D’Ascenzi, Flavio Pescatore, Valentina Giada, Franco Sarto, Patrizio Calò, Leonardo Schiavon, Maurizio Gregori, Dario Hadley, David M Drezner, Jonathan A Pelliccia, Antonio Corrado, Domenico Europace Clinical Research AIMS: Low QRS voltages (peak to peak <0.5 mV) in limb leads (LQRSV) on the athlete’s electrocardiogram (ECG) may reflect an underlying cardiomyopathy, mostly arrhythmogenic cardiomyopathy (ACM) or non-ischaemic left ventricular scar (NILVS). We studied the prevalence and clinical meaning of isolated LQRSV in a large cohort of competitive athletes. METHODS AND RESULTS: The index group included 2229 Italian competitive athletes [median age 18 years (16–25), 67% males, 97% Caucasian] without major ECG abnormalities at pre-participation screening. Three control groups included Black athletes (N = 1115), general population (N = 1115), and patients with ACM or NILVS (N = 58). Echocardiogram was performed in all athletes with isolated LQRSV and cardiac magnetic resonance (CMR) in those with ventricular arrhythmias or echocardiographic abnormalities. The isolated LQRSV pattern was found in 1.1% index athletes and was associated with increasing age (median age 28 vs. 18 years; P < 0.001), elite status (71% vs. 34%; P < 0.001), body surface area, and body mass index but not with sex, type of sport, and echocardiographic left ventricular mass. The prevalence of isolated LQRSV was 0.2% in Black athletes and 0.3% in young individuals from the general population. Cardiomyopathy patients had a significantly greater prevalence of isolated LQRSV (12%) than index athletes, Black athletes, and general population. Five index athletes with isolated LQSRV and exercise-induced ventricular arrhythmias underwent CMR showing biventricular ACM in 1 and idiopathic NILVS in 1. CONCLUSIONS: Unlike cardiomyopathy patients, the ECG pattern of isolated LQRSV was rarely observed in athletes. This ECG sign should prompt clinical work-up for exclusion of an underlying cardiomyopathy. Oxford University Press 2022-03-04 /pmc/articles/PMC9559913/ /pubmed/35243505 http://dx.doi.org/10.1093/europace/euab330 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Clinical Research Zorzi, Alessandro Bettella, Natascia Tatangelo, Mario Del Monte, Alvise Vessella, Teresina Poscolieri, Barbara Crescenzi, Cinzia Pegorin, Davide D’Ascenzi, Flavio Pescatore, Valentina Giada, Franco Sarto, Patrizio Calò, Leonardo Schiavon, Maurizio Gregori, Dario Hadley, David M Drezner, Jonathan A Pelliccia, Antonio Corrado, Domenico Prevalence and clinical significance of isolated low QRS voltages in young athletes( ) |
title | Prevalence and clinical significance of isolated low QRS voltages in young athletes( ) |
title_full | Prevalence and clinical significance of isolated low QRS voltages in young athletes( ) |
title_fullStr | Prevalence and clinical significance of isolated low QRS voltages in young athletes( ) |
title_full_unstemmed | Prevalence and clinical significance of isolated low QRS voltages in young athletes( ) |
title_short | Prevalence and clinical significance of isolated low QRS voltages in young athletes( ) |
title_sort | prevalence and clinical significance of isolated low qrs voltages in young athletes( ) |
topic | Clinical Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9559913/ https://www.ncbi.nlm.nih.gov/pubmed/35243505 http://dx.doi.org/10.1093/europace/euab330 |
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