Abstract
Background: Due to cardiac adaptations in athletes, the normal electrocardiogram (ECG) may be altered and abnormal patterns occur. Cardiovascular-related sudden death is a leading cause of mortality during sports. ECG interpretation in athletes therefore requires careful analysis to properly distinguish changes due to physiological adaptations from those suggestive of underlying pathology. The present study describes ECG changes and attempts to identify possible adaptive and maladaptive changes among a cohort of elite athletes of different sports in Port Harcourt, Nigeria. Subjects and Methods: Cross-sectional prospective study involving 339 subjects (16–35 years) comprising 170 athletes (63 males and 107 females) and 169 nonathletes (74 males and 95 females) serving as control were recruited. Anthropometric parameters and blood pressure indices were determined and physical examination conducted to exclude associated comorbidities. Electrocardiographic parameters were determined through standard procedure using a resting 12-lead ECG. Results: No significant differences were observed for anthropometric parameters and blood pressure indices between male athletes and male nonathletes; although, female athletes had significantly higher weight and body mass index than female nonathletes. Irrespective of gender, athletes had significantly lower heart rate, T-axis and significantly higher QT-intervals compared to nonathletes; with lower P-axis and higher PR-interval among male athletes compared to male nonathletes. The left ventricular hypertrophy was the most prevalent abnormality among athletes. Conclusion: Changes described are due majorly to physiologic adaptation. However, some mal adaptations suggestive of risk factors for possible sudden cardiac death were identified. We advise sports physicians to carefully interpret ECG features of athletes to distinguish physiological changes related to athletic conditioning from findings suggestive of pathology.
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