Key result
High-performance sports training over one year is linked to ~4-point higher rates of uncommon ECG abnormalities.
Why the study?
To determine ECG morphology in high-level athletes and assess how the duration of high-performance training and the type of sport influence the ECG.
Does the duration of training and the type of sport played increase the presence of abnormal (Group 2) ECG changes in high-performance athletes?
Cross-Sectional (n=273)
Outcome assessors (cardiologists interpreting ECGs) blinded to clinical history
No
Does the duration of training and the type of sport played increase the presence of abnormal (Group 2) ECG changes in high-performance athletes?
Absolute Event Rate: 8.3% vs 3.9%
p-value: p=0.05
Findings suggest that some 'training-unrelated' Group 2 ECG abnormalities may actually be physiologic adaptations to intense, prolonged athletic training, challenging strict ESC criteria.
Longer training associated with more Group 2 ECG changes; hypothesis-generating for physiologic adaptation, prospective studies needed before changing screening.
OBJECTIVE: To undertake an ECG in high level athletes to determine the morphology of the ECG and to assess the influences on the ECG of the amount of time in a high-performance programme and the type of sport played. DESIGN: Cross-sectional cohort study. SETTING: High-performance sports programme. INTERVENTIONS: Current symptoms (questionnaire) and length of time in a high-performance sports programme were recorded. Sports were classified as either high maximal oxygen uptake continuous, high maximal oxygen uptake repeated effort or static. An ECG was performed and classified by 2010 European Society of Cardiology guidelines into Groups 0 (normal), Group 1 (common and training-related ECG changes) and Group 2 (uncommon and training unrelated ECG changes). RESULTS: The following were recorded: length of time in high performance sport programme (mean 2.3 years), type of sport (Continuous 103, Repeated effort 133, Static 37), ECG changes Group 0 (n=83, 31%), Group 1 (n=173, 63%) and Group 2 (n=17, 6.2%). Athletes with an increased length of time in a high performance programme demonstrated a higher likelihood of Group 2 ECG changes when compared with Groups 0 and 1 (p=0.05). The questionnaire did not help detect athletes with Group 2 ECG changes. CONCLUSIONS: This study demonstrates that an increased length of time in a high performance programme was associated with an increased number of detectable Group 2 ECG changes. Overall, the further investigation rate was 6.2%.
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Verrall et al. (2019) conducted a cross-sectional in High-performance athletes (n=273). Increased length of time in a high-performance sports programme (>1 year) vs. Entrance athletes (<1 year in programme) was evaluated on Presence of Group 2 (uncommon and training unrelated) ECG changes based on 2010 European Society of Cardiology guidelines (p=0.05). An increased length of time in a high-performance sports programme (>1 year) was associated with a higher likelihood of uncommon, training-unrelated Group 2 ECG changes compared to entrance level athletes (8.3% vs 3.9%, p=0.05).
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