scholarly journals Electrocardiographic (ECG) Characteristics among Malaysian Athletes

2021 ◽  
Vol 50 (11) ◽  
pp. 3355-3363
Author(s):  
Mohamad Shariff A Hamid ◽  
Sazlina Shariff Ghazali ◽  
Ahmad Munawwar Helmi Salim ◽  
Kamarul Hashimy Hussein ◽  
Zulkarnain Jaafar ◽  
...  
Keyword(s):  
Sinus Bradycardia ◽  
Left Ventricular ◽  
Physiological Adaptation ◽  
Ecg Changes ◽  
Medical Practitioners ◽  
Factors Associated ◽  
Men 2 ◽  
Physiological Adaptations ◽  
Chinese Ethnicity ◽  
Electrocardiogram Ecg

The electrocardiogram (ECG) is a graphic representation of the heart's electrical activity. Although it has some limitations as a diagnostic or prognostic tool, it contains a wealth of information necessary for the proper care of a patient with a potential cardiovascular disease. Understanding the ECG changes among athletes would allow medical practitioners to distinguish between normal physiological adaptations and abnormal changes. However, there is limited data on the ECG characteristics among multi-ethnic athletes such as in Malaysia. This study aimed to determine the ECG characteristics and its associated factors among Malaysian national athletes. Malaysian national athletes annual pre-participation medical records were retrieved. Information on sociodemographic, sports and medical history including the 12-lead resting ECG tracings were extracted. ECG were assessed and categorised into normal, physiological adaptation changes, and abnormal ECG using the standardised ‘Seattle criteria’. Differences in ECG characteristics between genders, ethnic background, and type of sports was investigated. Additionally, factors associated with the ECG characteristics were assessed using multiple logistic regression. Majority of Malaysian national athletes had physiological adaptation ECG changes (61%). The most frequent changes were early repolarization, sinus bradycardia and isolated left ventricular hypertrophy. We found significantly higher prevalence of physiological adaptation changes among men (÷2(2,371) = 18.9; p = 0.001) and athletes of Chinese ethnicity (both genders) (÷2(2,356) = 13.8; p = 0.002). Factors associated with physiological ECG changes were men (OR=2.67; 95% CI= 1.68, 4.27; p<0.001) and Chinese ethnicity (OR=2.92; 95% CI=1.68, 4.27; p=0.039). Most athletes had physiological adaptation ECG changes which were significantly associated with male gender and Chinese ethnicity. This information would facilitate the development of a specific guideline in interpreting ECG among Malaysian athletes.

fMLP provokes coronary vasoconstriction and myocardial ischemia in rabbits

1988 ◽  
Vol 254 (3) ◽  
pp. H481-H486 ◽  
Author(s):  
M. N. Gillespie ◽  
D. C. Booth ◽  
B. J. Friedman ◽  
M. R. Cunningham ◽  
M. Jay ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Inflammatory Cell ◽  
Coronary Spasm ◽  
Inflammatory Cells ◽  
Left Ventricular ◽  
Ecg Changes ◽  
St Segment ◽  
Perfusion Defects ◽  
The Right ◽  
Electrocardiogram Ecg

Recent pathological studies of coronary arteries from humans with suspected coronary spasm have revealed an augmented intramural burden of inflammatory cells. To test the hypothesis that inappropriate activation of inflammatory cells participates in the evolution of coronary vasospasm, the present experiments employed a newly developed coronary arteriographic technique for use in pentobarbital-anesthetized rabbits to evaluate the coronary vasomotor actions of the nonselective inflammatory cell stimulant, N-formyl-L-methionyl-L-leucyl-L-phenylalanine (fMLP). In 10 of 10 animals, selective left intracoronary injection of 200 ng fMLP evoked profound left coronary narrowing accompanied in all cases by ST segment deviation and dysrhythmias. Thallium-201 scintigraphy demonstrated hypoperfusion of the left ventricular free wall and septum supplied by the spastic coronary artery. The fMLP-induced epicardial vaso-constriction, ischemic electrocardiogram (ECG) changes, and thallium perfusion defects were reversed by intravenous nitroglycerin. Neither the right coronary artery nor its distribution were influenced by left coronary injection of fMLP. Additional experiments in isolated, salt solution-perfused rabbit hearts demonstrated that fMLP failed to exert direct coronary vasoconstrictor effects. These observations indicate that the non-selective inflammatory cell stimulant, fMLP, provokes arteriographically demonstrable coronary spasm with attendant myocardial hypoperfusion and ischemic ECG changes in anesthetized rabbits. Such a model may be useful in exploring the dynamic role of inflammatory cells in development of coronary spasm.

scholarly journals Electrocardiography in pre-participation screening and current guidelines for participation in competitive sports

2016 ◽  
Vol 144 (1-2) ◽  
pp. 104-110 ◽  
Author(s):  
Ljubica Georgijevic ◽  
Lana Andric
Keyword(s):  
Ventricular Tachycardia ◽  
Qt Interval ◽  
Sinus Bradycardia ◽  
Left Ventricular ◽  
Polymorphic Ventricular Tachycardia ◽  
Ecg Changes ◽  
Sinus Arrhythmia ◽  
Intraventricular Conduction ◽  
Wave Inversion ◽  
St Segment

Electrocardiography (ECG) is especially significant in pre-participation screening due to its ability to discover or to rise a suspicion for certain cardiovascular diseases and conditions that represent a serious health risk in athletes. Common, conditionally benign and training related ECG changes are sinus bradycardia and sinus arrhythmia, first degree atrioventricular block, incomplete right bundle branch block, benign early repolarization, and isolated QRS voltage criteria for left ventricular enlargement. Uncommon ECG changes, unrelated to training, and some specific syndromes are ST segment depression and/or ? 2mm T wave inversion in two or more adjacent leads, intraventricular conduction disorder, Wolf-Parkinson-White syndrome, long QT interval syndrome, short QT interval syndrome, catecholaminergic polymorphic ventricular tachycardia, monomorphic ventricular extrasystole and benign ventricular tachycardia.

scholarly journals CHARACTERISTICS OF RESTING ECG AMONG SABAH PROFESSIONAL MALE FOOTBALLERS

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Mohamad Azwan Aziz ◽  
Redzal Abu Hanifah
Keyword(s):  
Blood Pressure ◽  
Sinus Bradycardia ◽  
Stress Test ◽  
Sports Participation ◽  
Exercise Stress Test ◽  
Left Ventricular ◽  
Exercise Stress ◽  
Cardiac Pathology ◽  
Wave Inversion ◽  
Electrocardiogram Ecg

The purpose of this study is to describe the resting electrocardiogram (ECG) seen among 176 professional male footballers from Sabah Football Association Club during preparticipation evaluation. Data were analysed retrospectively from 2017 to 2019. Majority of the players were Sabah natives (n=153, 87%) while the remaining were Malay footballers (n=23, 13%). Mean age of the players was 19.9 ± 3.1, mean body mass index was 22.6 kg/m2 ± 7, mean resting heart rate was 53.6 beats per minute ± 9.4, mean systolic blood pressure was 122.3 mmHg ± 12, and mean diastolic blood pressure was 65.1 mmHg ± 8.8. Using the International Criteria for ECG Interpretation in Athletes 2017 consensus guidelines, 8.5% (n=15) had abnormal ECG while 2.8% (n=5) had borderline ECG. The most common ECG changes seen in the normal findings were sinus bradycardia (n=123, 69.9%), early repolarization (n=115, 65.3%) and left ventricular hypertrophy (n=83,47.2%). Abnormal ECGs were abnormal t wave inversion (n=7,4.0%) and pre-excitation syndrome (n=5,2.9%). All footballers with abnormal ECG findings were subjected to further evaluation by a cardiologist using echocardiography assessment and exercise stress test. They passed the cardiology assessment; thus, they were deemed fit to play. ECG is a valuable tool for pre-participation health screening prior to exercise or sports participation, as it is vital for a physician to identify any abnormal ECG to minimise the risk of sudden cardiac death during exercise due to cardiac pathology.

Clinical assessment of the athlete’s heart: normal and abnormal ECGs in athletes

ESC CardioMed ◽  
2018 ◽  
pp. 2916-2920
Author(s):  
Alessandro Zorzi ◽  
Domenico Corrado
Keyword(s):  
Cardiovascular Disease ◽  
Athlete’S Heart ◽  
Physiological Adaptation ◽  
Ecg Changes ◽  
Increased Risk ◽  
Electrocardiogram Ecg ◽  
Ecg Abnormalities ◽  
Work Up ◽  
And Training ◽  
Athlete's Heart

The electrocardiogram (ECG) of trained athletes may show changes that represent the consequence of the heart’s adaptation to physical exercise (‘athlete’s heart’) such as enlarged cardiac chamber size and increased vagal tone. Physiological ECG changes must be differentiated from the ECG abnormalities secondary to an underlying cardiovascular disease that may be responsible for sudden cardiac death during exercise. The ECG changes of athletes are classified according to their prevalence, relation to exercise training, association with an increased risk of cardiovascular disease, and the need for further investigations: common ECG changes should be considered as a benign sign of physiological adaptation to exercise and do not require additional evaluation; on the other hand, in case of uncommon and training-unrelated abnormalities, which may be associated with an underlying cardiovascular disease, further work-up should be performed. This chapter reviews the abnormalities that may be found in an athlete’s ECG and proposes criteria for interpretation of such changes as normal or abnormal findings.

scholarly journals Prevalence of Abnormal and Borderline Electrocardiogram Changes in 13, 079 Chinese Amateur Marathon Runners

2020 ◽  
Author(s):  
Xu Wen ◽  
Yumin Huang ◽  
Tonghui Shen ◽  
Yinglan Gong ◽  
Ruiqing Dong ◽  
...  
Keyword(s):  
Qt Interval ◽  
Sinus Bradycardia ◽  
Premature Ventricular Contraction ◽  
Left Ventricular ◽  
Ecg Changes ◽  
Sinus Arrhythmia ◽  
Marathon Runners ◽  
St Segment ◽  
Prolonged Qt Interval ◽  
Prolonged Qt

Abstract The purpose of this study was to assess the prevalence of normal, borderline and abnormal ECG changes in marathon runners. The 12-lead ECG data of 13,079 amateur marathon runners between the ages of 18 and 35 years were included for analysis. The prevalence of ECG abnormalities among different gender groups was compared with chi-square tests. In terms of training-related changes, sinus bradycardia, sinus arrhythmia and left ventricular high voltage were found in approximately 15%, 5% and 3.28% of the participants, respectively. The incidence of right axis deviation in the marathon runners was 1.78%, which was slightly higher than the incidence of left axis deviation (0.88%). No more than 0.1% of the amateur marathon runners exhibited ST segment depression, T wave inversion (TWI), premature ventricular contraction, pathologic Q waves and prolonged QT interval. In conclusion, training-related ECG changes, including sinus bradycardia, sinus arrhythmia and left ventricular high voltage, were common in the amateur marathon runners. Most of abnormal ECG changes, including ST segment depression, TWI, premature ventricular contraction, pathologic Q waves and prolonged QT interval, were infrequently found in the amateur marathon runners.

scholarly journals Prevalence of abnormal and borderline electrocardiogram changes in 13, 079 Chinese amateur marathon runners

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Xu Wen ◽  
Yu-min Huang ◽  
Tong-Hui Shen ◽  
Ying-Lan Gong ◽  
Rui-qing Dong ◽  
...  
Keyword(s):  
Sinus Bradycardia ◽  
Premature Ventricular Contraction ◽  
Left Ventricular ◽  
Ecg Changes ◽  
Sinus Arrhythmia ◽  
Marathon Runners ◽  
St Segment ◽  
Prolonged Qt Interval ◽  
Prolonged Qt ◽  
Ecg Abnormalities

Abstract Background The 12-lead electrocardiogram (ECG) has been adopted as an important component of preparticipation cardiovascular screening. However, there are still controversies in the screening and few studies with a large sample size have reported the results of ECGs of marathon runners. Therefore, the purpose of this study was to assess the prevalence of normal, borderline, and abnormal ECG changes in marathon runners. Methods The 12-lead ECG data of 13,079 amateur marathon runners between the ages of 18 and 35 years were included for analysis. The prevalence of ECG abnormalities among different gender groups was compared with chi-square tests. Results In terms of training-related changes, sinus bradycardia, sinus arrhythmia, and left ventricular high voltage were found in approximately 15, 5, and 3.28% of the participants, respectively. The incidence of right axis deviation in the marathon runners was 1.78%, which was slightly higher than the incidence of left axis deviation (0.88%). No more than 0.1% of the amateur marathon runners exhibited ST-segment depression, T wave inversion (TWI), premature ventricular contraction, pathologic Q waves, and prolonged QT interval. Conclusions Training-related ECG changes, including sinus bradycardia, sinus arrhythmia, and left ventricular high voltage, were common in amateur marathon runners. Most abnormal ECG changes, including ST-segment depression, TWI, premature ventricular contraction, pathologic Q waves, and prolonged QT interval, were infrequently found in amateur marathon runners. The data also suggested Chinese amateur marathon runners may have a relatively lower prevalence of ECG abnormalities than black and white runners.

scholarly journals Time Course of ECG Depolarization and Repolarization Changes during Ischemia in PTCA Recordings

2004 ◽  
Vol 43 (01) ◽  
pp. 43-46 ◽  
Author(s):  
J. García ◽  
G. Wagner ◽  
R. Bailón ◽  
L. Sörnmo ◽  
P. Laguna ◽  
...  
Keyword(s):  
Time Course ◽  
Wave Amplitude ◽  
Temporal Evolution ◽  
Delayed Response ◽  
S Wave ◽  
Ecg Changes ◽  
T Complex ◽  
Karhunen Loeve Transform ◽  
Low Amplitude ◽  
Electrocardiogram Ecg

Summary Objectives: In this work we studied the temporal evolution of changes in the electrocardiogram (ECG) as a consequence of the induced ischemia during prolonged coronary angioplasty, comparing the time course of indexes reflecting depolarization and those reflecting repolarization. Methods: We considered both local (measured at specific points of the ECG) and global (obtained from the Karhunen-Loève transform) indexes. In particular, the evolution of Q, R and S wave amplitudes during ischemia was analyzed with respect to classical indexes such as ST level. As a measurement of sensitivity we used an Ischemic Changes Sensor (ICS), which reflects the capacity of an index to detect changes in the ECG. Results: The results showed that, in leads with low-amplitude ST-T complexes, the S wave amplitude was more sensitive in detecting ischemia than was the commonly used index ST60. It was found that in such leads the S wave amplitude initially exhibited a delayed response to ischemia when compared to ST60, but its performance was better from the second minute of occlusion. The global indexes describing the ST-T complex were, in terms of the ICS, superior to the S wave amplitude for ischemia detection. Conclusions: Ischemic ECG changes occur both at repolarization and depolarization, with alterations in the depolarization period appearing later in time. Local indexes are less sensitive to ischemia than global ones.

Mechanisms of angina in patients with biopsy-proven viral myocarditis: insights from intracoronary acetylcholine testing

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Seitz ◽  
V Martinez Pereyra ◽  
A Hubert ◽  
K Klingel ◽  
R Bekeredjian ◽  
...  
Keyword(s):  
Coronary Arteries ◽  
Coronary Spasm ◽  
Viral Myocarditis ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Funding Source ◽  
Pathophysiological Mechanism ◽  
Ecg Changes ◽  
Ventricular Ejection Fraction ◽  
Microvascular Spasm

Abstract Background Patients with myocarditis often present with angina pectoris despite unobstructed coronary arteries. The underlying pathophysiological mechanism of angina in these patients remains to be elucidated. Coronary artery spasm is a well-known cause of angina in patients with unobstructed coronary arteries. In this study, we sought to assess the frequency of coronary vasomotor disorders in patients with biopsy-proven viral myocarditis. Methods In total, 700 consecutive patients who underwent endomyocardial biopsy for suspected myocarditis between 2008 and 2018 were retrospectively screened. Of these patients, viral myocarditis was confirmed in 303 patients defined as histological/immunohistological evidence of myocardial inflammation and presence of viral genome confirmed by PCR. Of these patients, 34 patients had angina despite unobstructed coronary arteries and underwent intracoronary acetylcholine (ACh) provocation testing in search of coronary spasm. Epicardial spasm was defined as acetylcholine-induced reproduction of the patient's symptoms associated with ischemic ECG changes and &gt;90% epicardial vasoconstriction. Microvascular spasm was defined as symptom reproduction and ECG changes in the absence of significant epicardial vasoconstriction. Results Patients were 49±16 years old, 62% were male and left ventricular ejection fraction was 54±16%. Most frequent viruses were parvovirus B19 (PVB19, 59%) and human herpes virus 6 (HHV6, 26%), 2 patients had combined PVB19/HHV6 infection and 3 patients other herpesviruses (CMV, EBV, VZV). Epicardial spasm was observed in 10 patients (29%) during ACh testing and microvascular spasm was found in 11 patients (32%). The rate of coronary spasm (epicardial and microvascular) was higher in the PVB19 subgroup compared to HHV6 (80% vs. 33%, p=0.031). In particular, there was a higher prevalence of microvascular spasm in PVB19 compared to HHV6 (45% vs. 0%, p=0.018). Conclusion We observed a high prevalence of microvascular and epicardial spasm in patients with biopsy-proven viral myocarditis suggesting coronary spasm as a potential underlying mechanism for angina in these patients. Microvascular spasm was most often observed in patients with PVB19-associated myocarditis. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Robert-Bosch-Stiftung; Berthold-Leibinger-Stiftung

scholarly journals Impella CP Implantation during Cardiopulmonary Resuscitation for Cardiac Arrest: A Multicenter Experience

2021 ◽  
Vol 10 (2) ◽  
pp. 339
Author(s):  
Vassili Panagides ◽  
Henrik Vase ◽  
Sachin P. Shah ◽  
Mir B. Basir ◽  
Julien Mancini ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Survival Rate ◽  
Cardiopulmonary Resuscitation ◽  
Univariate Analysis ◽  
Cerebral Performance Category ◽  
Neurological Impairment ◽  
Left Ventricular ◽  
Circulatory Support ◽  
Factors Associated ◽  
Analysis Survival

Background: Impella CP is a left ventricular pump which may serve as a circulatory support during cardiopulmonary resuscitation (CPR) for cardiac arrest (CA). Nevertheless, the survival rate and factors associated with survival in patients undergoing Impella insertion during CPR for CA are unknown. Methods: We performed a retrospective multicenter international registry of patients undergoing Impella insertion during on-going CPR for in- or out-of-hospital CA. We recorded immediate and 30-day survival with and without neurologic impairment using the cerebral performance category score and evaluated the factors associated with survival. Results: Thirty-five patients had an Impella CP implanted during CPR for CA. Refractory ventricular arrhythmias were the most frequent initial rhythm (65.7%). In total, 65.7% of patients immediately survived. At 30 days, 45.7% of patients were still alive. The 30-day survival rate without neurological impairment was 37.1%. In univariate analysis, survival was associated with both an age < 75 years and a time from arrest to CPR ≤ 5 min (p = 0.035 and p = 0.008, respectively). Conclusions: In our multicenter registry, Impella CP insertion during ongoing CPR for CA was associated with a 37.1% rate of 30-day survival without neurological impairment. The factors associated with survival were a young age and a time from arrest to CPR ≤ 5 min.

scholarly journals An Exploration of Heart Failure Risk in Breast Cancer Patients Receiving Anthracyclines with or without Trastuzumab in Thailand: A Retrospective Study

2021 ◽  
Vol 11 (3) ◽  
pp. 484-493
Author(s):  
Jukapun Yoodee ◽  
Aumkhae Sookprasert ◽  
Phitjira Sanguanboonyaphong ◽  
Suthan Chanthawong ◽  
Manit Seateaw ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Cancer Patients ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Breast Cancer Patients ◽  
Ventricular Ejection Fraction ◽  
Factors Associated ◽  
Palliative Intent ◽  
Increased Risk

Anthracycline-based regimens with or without anti-human epidermal growth factor receptor (HER) 2 agents such as trastuzumab are effective in breast cancer treatment. Nevertheless, heart failure (HF) has become a significant side effect of these regimens. This study aimed to investigate the incidence and factors associated with HF in breast cancer patients treated with anthracyclines with or without trastuzumab. A retrospective cohort study was performed in patients with breast cancer who were treated with anthracyclines with or without trastuzumab between 1 January 2014 and 31 December 2018. The primary outcome was the incidence of HF. The secondary outcome was the risk factors associated with HF by using the univariable and multivariable cox-proportional hazard model. A total of 475 breast cancer patients were enrolled with a median follow-up time of 2.88 years (interquartile range (IQR), 1.59–3.93). The incidence of HF was 3.2%, corresponding to an incidence rate of 11.1 per 1000 person-years. The increased risk of HF was seen in patients receiving a combination of anthracycline and trastuzumab therapy, patients treated with radiotherapy or palliative-intent chemotherapy, and baseline left ventricular ejection fraction <65%, respectively. There were no statistically significant differences in other risk factors for HF, such as age, cardiovascular comorbidities, and cumulative doxorubicin dose. In conclusion, the incidence of HF was consistently high in patients receiving combination anthracyclines trastuzumab regimens. A reduced baseline left ventricular ejection fraction, radiotherapy, and palliative-intent chemotherapy were associated with an increased risk of HF. Intensive cardiac monitoring in breast cancer patients with an increased risk of HF should be advised to prevent undesired cardiac outcomes.

Sign in / Sign up

Export Citation Format

Share Document