Outcomes in athletes with marked ECG repolarization abnormalities

New England Journal of Medicine

Volumn 358, Issue 2, 2008, Pages 152-161

  Pelliccia, Antonio ^a,f   Di Paolo, Fernando M ^a   Quattrini, Filippo M ^a   Basso, Cristina ^b   Culasso, Franco ^c   Popoli, Gloria ^d   De Luca, Rosanna ^a   Spataro, Antonio ^a   Biffi, Alessandro ^a   Thiene, Gaetano ^b   Maron, Barry J ^e  

^a Italian National Olympic Committee   (Italy)

^b UNIVERSITY OF PADUA MEDICAL SCHOOL   (Italy)

^c SAPIENZA UNIVERSITY OF ROME   (Italy)

^d UNIVERSITY OF MODENA AND REGGIO EMILIA   (Italy)

^e MINNEAPOLIS HEART INSTITUTE FOUNDATION   (United States)

^f Institute of Sports Science   (Italy)

Author keywords

[No Author keywords available]

Indexed keywords

ADOLESCENT; ADULT; ARTICLE; ATHLETE; CARDIOMYOPATHY; CONTROLLED STUDY; DEMOGRAPHY; ECHOCARDIOGRAPHY; ELECTROCARDIOGRAM; FEMALE; FOLLOW UP; HEART ARREST; HEART DISEASE; HEART REPOLARIZATION; HUMAN; HYPERTROPHIC CARDIOMYOPATHY; MAJOR CLINICAL STUDY; MALE; OUTCOME ASSESSMENT; PRIORITY JOURNAL; CARDIOVASCULAR DISEASE; CASE CONTROL STUDY; ELECTROCARDIOGRAPHY; HEART ARRHYTHMIA; HEART MUSCLE; PATHOLOGY; SPORT; STATISTICAL MODEL; SUDDEN DEATH;

ADOLESCENT; ADULT; ARRHYTHMIAS, CARDIAC; CARDIOMYOPATHIES; CARDIOMYOPATHY, HYPERTROPHIC; CARDIOVASCULAR DISEASES; CASE-CONTROL STUDIES; DEATH, SUDDEN, CARDIAC; ELECTROCARDIOGRAPHY; FEMALE; FOLLOW-UP STUDIES; HUMANS; LOGISTIC MODELS; MALE; MYOCARDIUM; SPORTS;

EID: 38049158283     PISSN: 00284793     EISSN: 15334406     Source Type: Journal    
DOI: 10.1056/NEJMoa060781     Document Type: Article

References (33)

1. Maron BJ, Pelliccia A. The heart of trained athletes: cardiac remodeling and the risks of sports, including sudden death. Circulation 2006;114:1633-44.
2. Huston TP, Puffer JC, Rodney WM. The athletic heart syndrome. N Engl J Med 1985;313:24-32.
3. Venerando A, Rulli V. Frequency, morphology and meaning of the electrocardiographic anomalies found in Olympic marathon runners and walkers. J Sports Med Phys Fitness 1964;50:135-41.
4. Hanne-Paparo N, Wendkos MH, Brunner DT. T wave abnormalities in the electrocardiograms of top-ranking athletes without demonstrable organic heart disease. Am Heart J 1971;81:743-7.
5. Lichtman J, O'Rourke RA, Klein A, Karliner JS. Electrocardiogram of the athlete: alterations simulating those of organic heart disease. Arch Intern Med 1973;132:763-70.
6. Roeske WR, O'Rourke RA, Klein A, Leopold G, Karliner JS. Noninvasive evaluation of ventricular hypertrophy in professional athletes. Circulation 1976;53:286-91.
7. Zeppilli P, Pirrami MM, Sassara M, Fenici R. T wave abnormalities in top ranking athletes: effects of isoproterenol, atropine, and physical exercise. Am Heart J 1980;100:213-22.
8. Nishimura T, Kambara H, Chen CH, Yamada Y, Kawai C. Noninvasive assessment of T-wave abnormalities on precordial electrocardiograms in middle-aged professional bicyclists. J Electrocardiol 1981;14:357-64.
9. Oakley DG, Oakley CM. Significance of abnormal electrocardiograms in highly trained athletes. Am J Cardiol 1982;50:985-9.
10. Balady GJ, Cadigan JB, Ryan TJ. Electrocardiogram of the athlete: an analysis of 289 professional football players. Am J Cardiol 1984;53:1339-43.
11. Douglas PS, O'Toole ML, Hiller WDB, Hackney K, Reichek N. Electrocardiographic diagnosis of exercise-induced left ventricular hypertrophy. Am Heart J 1988;116:784-90.
12. Zehender M, Meinertz T, Keul J, Just H. ECG variants and cardiac arrhythmias in athletes: clinical relevance and prognostic importance. Am Heart J 1990;119:1378-91.
13. Björnstad H, Smith G, Storstein L, Meen HD, Hals O. Electrocardiographic and echocardiographic findings in top athletes, athletic students and sedentary controls. Cardiology 1993;82:66-74.
14. Pelliccia A, Maron BJ, Culasso F, et al. Clinical significance of abnormal electrocardiographic patterns in trained athletes. Circulation 2000;102:278-84.
15. Niimura H, Bachinski LL, Sangwatanaroj S, et al. Mutations in the gene for human cardiac myosin-binding protein C and late-onset familial hypertrophic cardiomyopathy. N Engl J Med 1998;338:1248-57.
16. Maron BJ, Niimura H, Casey SA, et al. Development of left ventricular hypertrophy in adults with hypertrophic cardiomyopathy caused by cardiac myosin-binding protein C gene mutations. J Am Coll Cardiol 2001;38:315-21.
17. Maron BJ, Seidman JG, Seidman CE. Proposal for contemporary screening strategies in families with hypertrophic cardiomyopathy. J Am Coll Cardiol 2004;44:2125-32.
18. Pelliccia A, Maron BJ. Preparticipation cardiovascular evaluation of the competitive athlete: perspectives from the 30-year Italian experience. Am J Cardiol 1995;75:827-9.
19. Pelliccia A, Maron BJ, Spataro A, Proshan M, Spirito P. The upper limit of physiologic cardiac hypertrophy in highly trained elite athletes. N Engl J Med 1991;324:295-301.
20. Pelliccia A, Spataro A, Maron BJ. Prospective echocardiographic screening for coronary artery anomalies in 1,360 elite competitive athletes. Am J Cardiol 1993;72:978-9.
21. Maron BJ, McKenna WJ, Danielson GK, et al. American College of Cardiology/European Society of Cardiology clinical expert consensus document on hypertrophic cardiomyopathy: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents and the European Society of Cardiology Committee for Practice Guidelines. J Am Coll Cardiol 2003;42:1687-713.
22. Gavazzi A, De Maria R, Renosto G, et al. The spectrum of left ventricular size in dilated cardiomyopathy: clinical correlates and prognostic implications. Am Heart J 1993;125:410-22.
23. Maron BJ, Pelliccia A, Spirito P. Cardiac disease in young trained athletes: insights into methods for distinguishing athlete's heart from structural heart disease, with particular emphasis on hypertrophic cardiomyopathy. Circulation 1995;91:1596-601.
24. Pelliccia A, Culasso F, Di Paolo FM, Maron BJ. Physiologic left ventricular cavity dilatation in elite athletes. Ann Intern Med 1999;130:23-31.
25. McKenna WJ, Thiene G, Nava A, et al. Diagnosis of arrhythmogenic right ventricular dysplasia/cardiomyopathy. Br Heart J 1994;71:215-8.
26. Armitage P, Berry G. Statistical methods in medical research. 3rd ed. Oxford, England: Blackwell Scientific, 1994:277.
27. Antzelevitch C, Brugada P, Brugada J, Brugada R, Towbin JA, Nademanee K. Brugada syndrome: 1992-2002: a historical perspective. J Am Coll Cardiol 2003;41:1665-71.
28. Maron BJ, Wolfson JK, Ciró E, Spirito P. Relation of electrocardiographic abnormalities and patterns of left ventricular hypertrophy identified by 2-dimensional echocardiography in patients with hypertrophic cardiomyopathy. Am J Cardiol 1983;51:189-94.
29. Thiene G, Nava A, Corrado D, Rossi L, Pennelli N. Right ventricular cardiomyopathy and sudden death in young people. N Engl J Med 1988;318:129-33.
30. Sharma S, Whyte G, Elliot P, et al. Electrocardiographic changes in 1000 highly trained junior elite athletes. Br J Sports Med 1999;33:319-24.
31. Serra-Grima R, Estorch M, Carrió I, Subirana M, Bernà L, Prat T. Marked ventricular repolarization abnormalities in highly trained athletes' electrocardiograms: clinical and prognostic implications. J Am Coll Cardiol 2000;36:1310-6.
32. Corrado D, Basso C, Rizzoli G, Schiavon M, Thiene G. Does sports activity enhance the risk of sudden death in adolescents and young adults? J Am Coll Cardiol 2003;42:1959-63.
33. Pelliccia A, Di Paolo FM, Corrado D, et al. Evidence for efficacy of the Italian national pre-participation screening programme for identification of hypertrophic cardiomyopathy in competitive athletes. Eur Heart J 2006;27:2196-200.