What question did this study set out to answer?

To determine the prevalence, clinical characteristics, and diagnostic relevance of isolated low QRS voltages in limb leads among competitive athletes.

December 30, 2021EP EuropaceOpen Access

Prevalence and clinical significance of isolated low QRS voltages in young athletes

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Why the study?

Low QRS voltages in limb leads on an athlete's ECG may reflect cardiomyopathy, but the prevalence and clinical significance of isolated LQRSV in competitive athletes remain unclear.

What is the prevalence and clinical significance of isolated low QRS voltages on the ECG of young competitive athletes?

Population

2229 Italian competitive athletes plus three control groups

Comparison

Italian competitive athletes vs Black athletes, general population, and patients with ACM or NILVS

Design

Cohort study

Authors

AZAlessandro ZorziElectrophysiology NBNatascia BettellaUniversity of Padua MTMario TatangeloPoliclinico Casilino

Discussion

Member takes

Implication

Isolated LQRSV warrants targeted evaluation in athletes to exclude cardiomyopathy; leaves open its independent prognostic value in asymptomatic screened athletes.

Key Points

To determine the prevalence, clinical characteristics, and diagnostic relevance of isolated low QRS voltages in limb leads among competitive athletes.
Screened 2229 Italian competitive athletes (median age 18 years, 67% male, 97% Caucasian) alongside control cohorts of Black athletes (N = 1115), general population controls (N = 1115), and patients with arrhythmogenic cardiomyopathy or non-ischaemic left ventricular scar (N = 58).
Conducted echocardiograms on all athletes exhibiting isolated low QRS voltages and performed cardiac magnetic resonance imaging in athletes with ventricular arrhythmias or echocardiographic abnormalities.
Isolated low QRS voltages occurred in 1.1% of index athletes, 0.2% of Black athletes, and 0.3% of general population controls, compared to 12% in cardiomyopathy patients.
Low voltages in index athletes were associated with older age (median 28 vs. 18 years; P < 0.001), elite status (71% vs. 34%; P < 0.001), body surface area, and body mass index, but not with sex, sport type, or left ventricular mass.
Cardiac magnetic resonance in five athletes with low voltages and exercise-induced ventricular arrhythmias revealed biventricular arrhythmogenic cardiomyopathy in one athlete and idiopathic non-ischaemic left ventricular scar in another.

Structured PICO

What is the prevalence and clinical significance of isolated low QRS voltages on the ECG of young competitive athletes?

Population

4,517 individuals, comprising an index group of 2,229 Italian competitive athletes (median age 18, 67% male, 97% Caucasian) without major ECG abnormalities at pre-participation screening, and three control groups: Black athletes (n=1,115), general population (n=1,115), and patients with arrhythmogenic cardiomyopathy or non-ischaemic left ventricular scar (n=58).

Outcome

Prevalence of isolated low QRS voltages (peak to peak <0.5 mV) in limb leadssurrogate

Isolated low QRS voltages are rare in healthy athletes (1.1%) compared to cardiomyopathy patients (12%) and should prompt further clinical work-up to exclude underlying cardiomyopathy.

Cite This Study

Zorzi et al. (2021) studied this question.

synapsesocial.com/papers/6a741da2bac7bc5744eb0185 https://doi.org/10.1093/europace/euab330

Topics

Cardiomyopathy Sports cardiology

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Implication

Isolated LQRSV warrants targeted evaluation in athletes to exclude cardiomyopathy; leaves open its independent prognostic value in asymptomatic screened athletes.

Prevalence and clinical significance of isolated low QRS voltages in young athletes

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Prevalence and clinical significance of isolated low QRS voltages in young athletes

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider