Black ethnicity in professional football players was associated with a significantly higher prevalence of anterior T-wave inversion compared to non-black players (11.3% vs 1.3%; p<0.001).
Cross-Sectional (n=11,595)
Yes
Does the prevalence and clinical significance of anterior T-wave inversion differ between black and non-black professional football players?
Anterior T-wave inversion is nearly nine times more frequent in black professional football players compared to non-black players, and its presence in non-black athletes warrants further investigation due to the risk of underlying cardiomyopathy.
Absolute Event Rate: 11.3% vs 1.3%
p-value: p=<0.001
Abstract Introduction Anterior T-wave inversion (ATWI) confined to lead V1-V4 preceded by convex ST elevation has been considered as a normal finding in athletes with black ethnicity. We aimed to assess the prevalence and significance of ATWI in professional black and non-black football players from the United Kingdom. Methods In this observational cross-sectional study, football players underwent preparticipation screening as part of the English Football Association (FA) programme in 2017-2024. Each player underwent a health questionnaire, 12-lead ECG and transthoracic echocardiogram. Clinical outcomes were assessed by an expert sports cardiologist. Each player was categorised into black or non-black according to their ethnicity. ATWI was defined as TWI confined to lead V1 to V3 or V4. Results 11,595 football players were studied, comprising 9,638 (83.1%) males and 1,957 (16.9%) females. 3,012 (26.0%) players were of black ethnicity and 8,583 (74.0%) were non-black. The non-black group were predominantly white (98%) with the remainder being Asian (2%). The mean age of black players was 17.3±3.9 years vs 19.2±4.7 years in non-black players (p0.001). ATWI was observed in 341 (11.3%) black players vs 115 (1.3%) non-black players (p0.001). ATWI was more common in males compared to females among black players (336 11.6% vs 5 4.8%; p=0.03). Among non-black players, ATWI was less common in males (80 1.2% vs 35 1.9%; p=0.03). No black players with ATWI had major cardiac pathology associated with SCD, whereas one (0.9%) non-black player was diagnosed with arrhythmogenic cardiomyopathy (p=0.31). Minor cardiac conditions were identified in five (1.5%) black players and two (1.7%) non-black players (p=1.00). Among the five black players with minor cardiac pathology, two had aortic root dilatation, one had a patent ductus arteriosus, one had a small atrial septal defect, and one had moderate valvular regurgitation. Among the two non-black players with minor cardiac conditions, one had a patent ductus arteriosus and one had moderate valvular regurgitation. Both black and non-black players with minor cardiac pathology did not show other ECG changes apart from ATWI. Conclusion ATWI was observed nearly nine times more frequently in black football players than in non-black players. ATWI in non-black athletes should prompt further investigation because of the rarity and risk of underlying cardiomyopathy.
Yamagata et al. (Mon,) conducted a cross-sectional in Anterior T-wave inversion (n=11,595). Black ethnicity vs. Non-black ethnicity was evaluated on Prevalence of anterior T-wave inversion (ATWI) (p=<0.001). Black ethnicity in professional football players was associated with a significantly higher prevalence of anterior T-wave inversion compared to non-black players (11.3% vs 1.3%; p<0.001).