Key result
Athlete ECGs vary by sport and ethnicity, showing more sinus bradycardia and early repolarization in soccer.
Why the study?
Granular normative ECG data characterizing variation by ethnicity and sport played in professional male athletes were needed.
What is the prevalence and variance of electrocardiographic findings by sport played and ethnicity in professional male athletes?
Cross-Sectional (n=753)
No
What is the prevalence and variance of electrocardiographic findings by sport played and ethnicity in professional male athletes?
Professional male athletes exhibit sport-specific and ethnicity-specific variations in baseline ECG findings, such as higher rates of early repolarization and left ventricular hypertrophy in Black football players.
Athlete ECG screening may benefit from sport- and ethnicity-specific norms; cross-sectional data leaves open outcome validation.
OBJECTIVE: To generate granular normative electrocardiogram (ECG) data and characterize the variation by ethnicity and sport played. DESIGN: Cross-sectional study; ECGs were collected from preseason screening programs from 2012 to 2019 and interpreted in accordance with athlete-specific guidelines. SETTING: Of the professional athletes based in Vancouver, the North Shore Heart Centre performs the annual preparticipation ECG screening. PARTICIPANTS: Seven hundred fifty-three professional male athletes competing in hockey, football, lacrosse, skiing, and snowboarding. INTERVENTIONS: Independent variables include commonly transcribed electrocardiographic findings, for example, those indicating benign and pathologic findings. MAIN OUTCOME MEASURES: Prevalence of and variance in electrocardiographic findings by sport played and ethnicity. RESULTS: Of the 753 athletes, 171 (22.3%) were National Hockey League, 358 (47.5%) were Canadian Football League, 163 (21.6%) were Major League Soccer and/or the Canadian National Soccer team, and 61 (8%) others. The most common finding, sinus bradycardia, was more likely in both soccer (P < 0.001) and hockey (P < 0.001) versus football players. Early repolarization (ER) was more likely in soccer players versus both hockey (P < 0.001) and football players (P = 0.001). Within football, Black athletes (BA) were more likely than White athletes to display ER (P = 0.009), left ventricular hypertrophy (P = 0.004), and nonspecific ST changes (P = 0.027). CONCLUSION: Our study contributes to the generation of normative data for ECG findings while accounting for ethnic and sport-specific variation. The expected clinical presentation of endurance athletes, including soccer players, and the possible predisposition of BA to develop distinct adaptations can augment clinical care by delineating physiology from pathologic changes.
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Raman et al. (2021) conducted a cross-sectional in Professional male athletes (n=753). Electrocardiogram (ECG) screening vs. Variation by sport played and ethnicity was evaluated on Prevalence of and variance in electrocardiographic findings by sport played and ethnicity. ECG findings in professional male athletes varied by sport and ethnicity, with sinus bradycardia and early repolarization being more common in soccer players than football players (P<0.001).
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