Signifi cance of deep T-wave inversions in asymptomatic athletes with normal cardiovascular examinations: Practical solutions for managing the diagnostic conundrum

British Journal of Sports Medicine

Volumn 46, Issue SUPPL. 1, 2012, Pages

  Wilson, M G ^a   Sharma, S ^b   Carre F ^c   Charron, P ^d   Richard, P ^e   O'Hanlon, R ^f   Prasad, S K ^g   Heidbuchel, H ^h   Brugada, J ⁱ   Salah, O ^a   Sheppard, M ^j   George, K P ^k   Whyte, G ^k,l   Hamilton, B ^a   Chalabi, H ^a  

^a ASPETAR ORTHOPAEDIC AND SPORTS MEDICINE HOSPITAL   (Qatar)

^b ST GEORGE S HOSPITAL   (United Kingdom)

^c UNIVERSITÉ DE RENNES 1   (France)

^d SORBONNE UNIVERSITÉ   (France)

^e PITIÉ SALPÊTRIÈRE HOSPITAL   (France)

^f ST VINCENT S UNIVERSITY HOSPITAL   (Ireland)

^g ROYAL BROMPTON AND HAREFIELD NHS FOUNDATION TRUST   (United Kingdom)

^h UNIVERSITY OF LEUVEN   (Belgium)

ⁱ UNIVERSITY OF BARCELONA   (Spain)

^j ROYAL BROMPTON HOSPITAL   (United Kingdom)

^k LIVERPOOL JOHN MOORES UNIVERSITY   (United Kingdom)

^l Centre for Sports Cardiology   (United Kingdom)

more..

Author keywords

[No Author keywords available]

Indexed keywords

ATHLETE; CLINICAL PATHWAY; EARLY DIAGNOSIS; ELECTROCARDIOGRAPHY; GENETIC SCREENING; HEART RIGHT VENTRICLE DYSPLASIA; HUMAN; HYPERTROPHIC CARDIOMYOPATHY; METHODOLOGY; PHYSICAL EXAMINATION; PHYSIOLOGY; PROGNOSIS; REVIEW; RISK ASSESSMENT; SPORT; SUDDEN DEATH;

ARRHYTHMOGENIC RIGHT VENTRICULAR DYSPLASIA; ATHLETES; CARDIOMYOPATHY, HYPERTROPHIC; CRITICAL PATHWAYS; DEATH, SUDDEN, CARDIAC; EARLY DIAGNOSIS; ELECTROCARDIOGRAPHY; GENETIC TESTING; HUMANS; PHYSICAL EXAMINATION; PROGNOSIS; RISK ASSESSMENT; SPORTS;

EID: 85047686880     PISSN: 03063674     EISSN: 14730480     Source Type: Journal    
DOI: 10.1136/bjsports-2011-090838     Document Type: Article

References (37)

1. Zeller L, Giladi H, Golan R, et al. Sudden death in a young soccer player with marked electrocardiographic repolarization abnormalities. Clin J Sport Med 2010;20:66-8.
2. Wilson MG, Chatard JC, Hamilton B, et al. Signifi cance of deep T-wave inversions in an asymptomatic athlete with a family history of sudden death. Clin J Sport Med 2011;21:138-40.
3. Maron BJ, Ackerman MJ, Nishimura RA, et al. Task Force 4: HCM and other cardiomyopathies, mitral valve prolapse, myocarditis, and Marfan syndrome. J Am Coll Cardiol 2005;45:1340-5. (Pubitemid 40523165)
4. Pelliccia A, Fagard R, Bjørnstad HH, et al. Recommendations for competitive sports participation in athletes with cardiovascular disease: a consensus document from the Study Group of Sports Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology. Eur Heart J 2005;26:1422-45.
5. Sharma S. Athlete's heart-effect of age, sex, ethnicity and sporting discipline. Exp Physiol 2003;88:665-9. (Pubitemid 37121741)
6. Corrado D, Pelliccia A, Heidbuchel H, et al. Recommendations for interpretation of 12-lead electrocardiogram in the athlete. Eur Heart J 2010;31:243-59.
7. Basavarajaiah S, Boraita A, Whyte G, et al. Ethnic differences in left ventricular remodeling in highly-trained athletes relevance to differentiating physiologic left ventricular hypertrophy from hypertrophic cardiomyopathy. J Am Coll Cardiol 2008;51:2256-62. (Pubitemid 351754996)
8. Pelliccia A, Maron BJ, Culasso F, et al. Clinical signifi cance of abnormal electrocardiographic patterns in trained athletes. Circulation 2000;102:278-84. (Pubitemid 30457576)
9. Pelliccia A, Di Paolo FM, Quattrini FM, et al. Outcomes in athletes with marked ECG repolarization abnormalities. N Engl J Med 2008;358:152-61.
10. Pelliccia A, Culasso F, Di Paolo FM, et al. Prevalence of abnormal electrocardiograms in a large, unselected population undergoing pre-participation cardiovascular screening. Eur Heart J 2007;28:2006-10. (Pubitemid 47579542)
11. Papadakis M, Basavarajaiah S, Rawlins J, et al. Prevalence and signifi cance of T-wave inversions in predominantly Caucasian adolescent athletes. Eur Heart J 2009;30:1728-35.
12. Sharma S, Whyte G, Elliott P, et al. Electrocardiographic changes in 1000 highly trained junior elite athletes. Br J Sports Med 1999;33:319-24. (Pubitemid 29460605)
13. Bjørnstad H, Storstein L, Meen HD, et al. Electrocardiographic fi ndings of repolarization in athletic students and control subjects. Cardiology 1994;84:51-60. (Pubitemid 24032318)
14. Papadakis M, Carre F, Kervio G, et al. The prevalence, distribution, and clinical outcomes of electrocardiographic repolarization patterns in male athletes of African/Afro-Caribbean origin. Eur Heart J 2011;32:2304-13.
15. Rawlins J, Carre F, Kervio G, et al. Ethnic differences in physiological cardiac adaptation to intense physical exercise in highly trained female athletes. Circulation 2010;121:1078-85.
16. Wilson MG, Chatard JC, Carre F, et al. Prevalence of electrocardiographic abnormalities in West-Asian and African male athletes. Br J Sports Med 2012;46:341-7.
17. Elliott P, Andersson B, Arbustini E, et al. Classifi cation of the cardiomyopathies: a position statement from the European Society Of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J 2008;29:270-6.
18. Basso C, Corrado D, Marcus FI, et al. Arrhythmogenic right ventricular cardiomyopathy. Lancet 2009;373:1289-300.
19. Corrado D, Basso C, Thiene G, et al. Spectrum of clinicopathologic manifestations of arrhythmogenic right ventricular cardiomyopathy/dysplasia: a multicenter study. J Am Coll Cardiol 1997;30:1512-20. (Pubitemid 27486470)
20. Brugada J, Brugada R, Brugada P. Determinants of sudden cardiac death in individuals with the electrocardiographic pattern of Brugada syndrome and no previous cardiac arrest. Circulation 2003;108:3092-6. (Pubitemid 38031797)
21. Firoozi S, Sharma S, McKenna WJ. Risk of competitive sport in young athletes with heart disease. Heart 2003;89:710-14. (Pubitemid 36760623)
22. Bellenger NG, Francis JM, Davies CL, et al. Establishment and performance of a magnetic resonance cardiac function clinic. J Cardiovasc Magn Reson 2000;2:15-22. (Pubitemid 30183732)
23. Bellenger NG, Grothues F, Smith GC, et al. Quantifi cation of right and left ventricular function by cardiovascular magnetic resonance. Herz 2000;25:392-9. (Pubitemid 30470078)
24. Rickers C, Wilke NM, Jerosch-Herold M, et al. Utility of cardiac magnetic resonance imaging in the diagnosis of hypertrophic cardiomyopathy. Circulation 2005;112:855-61. (Pubitemid 41170072)
25. Maron BJ, Lindberg J, Haas TS, et al. Disparity between unusual left ventricular morphology and clinical presentation and course in hypertrophic cardiomyopathy. Am J Cardiol 2010;105:1643-4.
26. Wilson MG, Chandra N, Papadakis M, et al. Hypertrophic cardiomyopathy and ultra-endurance running-two incompatible entities? J Cardiovasc Magn Reson 2011;13:77.
27. McCrohon JA, Moon JC, Prasad SK, et al. Differentiation of heart failure related to dilated cardiomyopathy and coronary artery disease using gadolinium-enhanced cardiovascular magnetic resonance. Circulation 2003;108:54-9. (Pubitemid 36859020)
28. Moon JC, Fisher NG, McKenna WJ, et al. Detection of apical hypertrophic cardiomyopathy by cardiovascular magnetic resonance in patients with non-diagnostic echocardiography. Heart 2004;90:645-9. (Pubitemid 38668538)
29. Popovic ZB, Kwon DH, Mishra M, et al. Association between regional ventricular function and myocardial fi brosis in hypertrophic cardiomyopathy assessed by speckle tracking echocardiography and delayed hyperenhancement magnetic resonance imaging. J Am Soc Echocardiogr 2008;21:1299-305.
30. Gandjbakhch E, Gackowski A, Tezenas du Montcel S, et al. Early identifi cation of mutation carriers in familial hypertrophic cardiomyopathy by combined echocardiography and tissue Doppler imaging. Eur Heart J 2010;31:1599-607.
31. Bauce B, Basso C, Rampazzo A, et al. Clinical profi le of four families with arrhythmogenic right ventricular cardiomyopathy caused by dominant desmoplakin mutations. Eur Heart J 2005;26:1666-75. (Pubitemid 41389699)
32. Charron P, Arad M, Arbustini E, et al. Genetic counselling and testing in cardiomyopathies: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J 2010;31:2715-26.
33. Richard P, Charron P, Carrier L, et al. Hypertrophic cardiomyopathy: distribution of disease genes, spectrum of mutations, and implications for a molecular diagnosis strategy. Circulation 2003;107:2227-32. (Pubitemid 36547217)
34. Fressart V, Duthoit G, Donal E, et al. Desmosomal gene analysis in arrhythmogenic right ventricular dysplasia/cardiomyopathy: spectrum of mutations and clinical impact in practice. Europace 2010;12:861-8.
35. Heidbüchel H, Corrado D, Biffi A, et al. Recommendations for participation in leisure-time physical activity and competitive sports of patients with arrhythmias and potentially arrhythmogenic conditions. Part II: ventricular arrhythmias, channelopathies and implantable defi brillators. Eur J Cardiovasc Prev Rehabil 2006;13:676-86. (Pubitemid 44462668)
36. Gersh BJ, Maron BJ, Bonow RO, et al. 2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2011;124:e783-831.
37. Pelliccia A, Dipaolo FM. Athletes with abnormal repolarization pattern and structurally normal heart can participate in competitive sport a lifelong experience. J Am Coll Cardiol 2011;58:883-4.