Abstract 19575: Prevalence of Abnormal T-wave Inversions in European and American Athletes and its Association with Abnormal Echocardiogram

Abstract

Background: Electrocardiographic (ECG) evaluation is one of the primary tools utilized to screen for increased risk of sudden cardiac death in athletes. Recent study by Sheikh et al. proposed a further refinement to the Seattle criteria, known as the refined criteria. The objective of this study was to compare the prevalence of abnormal T-wave inversions (TWI) using the refined criteria in an American and European cohort and to evaluate the association of abnormal TWI with abnormal echocardiogram in the American cohort. Methods: Collegiate athletes at a single university underwent prospective collection of medical history, physical examination, 12-lead ECG, and 2-dimensional echocardiography from 2004 to 2013. ECG analysis of 1755 athletes was performed to asses for TWI as outlined by the refined criteria. Subjects were further classified by race, gender and area of TWI on ECG and compared to 5505 European athletes. Results: Of the 1755 American athletes, 49% were males and 1.3% had abnormal TWI. European cohort included 79% males and 3.9% abnormal TWI. Higher prevalence of abnormal TWI were noted in black athletes compared to white athletes in the American cohort (2% and 1.1% respectively). European counterpart had similar findings with 6% of black athletes and 3.3% of white athletes having abnormal TWI. In the American cohort abnormal TWI were distributed unequally within the anterior, lateral and antero-lateral leads (30%, 4% and 65% respectively). Only one American athlete (3.5%) with abnormal TWI had an abnormal echocardiogram. Conclusion: Incorporation of ECG assessment has been proposed as part of the preparticipation screening of athletes in United States. Comparison of American and European athletes showed a 67% lower prevalence of abnormal TWI in the American athletes. Only one American athlete with abnormal TWI had an abnormal echocardiogram. We conclude that abnormal TWI alone has a weak association with an abnormal echocardiogram in American college athletes.