AI Article Synopsis
- The study explores how electrocardiograms (ECGs) can help distinguish between heart changes in elite athletes and those due to dilated cardiomyopathy (DCM).
- ECG abnormalities were found in 73% of DCM patients, with common issues including low voltages and T-wave inversions, while only two athletes had abnormal readings.
- The ECG showed a sensitivity of 73% and high specificity (93%) for identifying DCM compared to normal physiological changes in athletes, indicating its potential value in clinical differentiation.
Article Abstract
Background: Physiological cardiac remodelling in highly trained athletes may overlap with dilated cardiomyopathy (DCM).
Objectives: The aim of this study was to investigate the role of the electrocardiogram (ECG) in differentiating between physiological and pathological remodelling.
Methods: The study population consisted of 30 patients with DCM who revealed a pathogenic variant at genetic testing and 30 elite athletes with significant cardiac remodelling defined by a left ventricular (LV) end-diastolic diameter >62 mm and/or LV ejection fraction between 45% and 50%.
Results: The ECG was abnormal in 22 (73%) patients with DCM. The most common abnormalities were low voltages (n = 14, 47%), lateral T-wave inversion (TWI) (n = 6, 20%), ventricular ectopic beats (n = 5, 17%) and anterior TWI (n = 4, 13). Two athletes revealed an abnormal ECG: complete left bundle branch block (LBBB) in one case and atrial flutter in the other. The sensitivity, specificity and accuracy of the ECG in differentiating DCM from physiological adaptation to exercise in athletes was 73% (confidence interval [CI]: 54%-88%), 93% (CI: 78%-99%) and 0.83 (CI: 0.71-0.92) respectively.
Conclusions: While the ECG is usually normal in athletes exhibiting significant LV dilatation and/or systolic dysfunction, this test is often abnormal in patients with DCM harbouring a pathogenic variant. Low voltages in the limb leads and lateral TWI are the most common abnormalities.
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| http://dx.doi.org/10.1111/eci.13837 | DOI Listing |
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