Jessica J Orchard, Jonathan A Drezner, Hariharan Raju, Rajesh Puranik, Belinda Gray, Maria Brosnan, Robert N Doughty, Bruce Hamilton, Tim Driscoll, Angus J Davis, Emma Buckthorpe, Simon Eggleton, Aaron Baggish, Andre La Gerche, John W Orchard
{"title":"孤立的前t波倒置在优秀运动员：患病率和临床相关性的性别和运动学科。","authors":"Jessica J Orchard, Jonathan A Drezner, Hariharan Raju, Rajesh Puranik, Belinda Gray, Maria Brosnan, Robert N Doughty, Bruce Hamilton, Tim Driscoll, Angus J Davis, Emma Buckthorpe, Simon Eggleton, Aaron Baggish, Andre La Gerche, John W Orchard","doi":"10.1161/JAHA.125.042435","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Cardiac screening of elite athletes is common internationally. Female athletes are reported to have a higher proportion of abnormal screening ECGs compared with male athletes, despite lower rates of sudden cardiac death. T-wave inversion in leads V<sub>2</sub> and V<sub>3</sub> (TWI<sub>V2-3</sub>) is considered abnormal for athletes aged ≥16 years, but there are knowledge gaps in prevalence and clinical outcomes.</p><p><strong>Methods: </strong>Data were obtained from the ARENA (Australasian Registry of ECGs of National Athletes) project and combined with previous athlete cohort studies from Australia and New Zealand. Sporting disciplines included Olympic sports (summer and winter), Australian football, cricket, football (soccer), and netball. Logistic regression calculated adjusted odds ratios with 95% CIs for the odds of isolated TWI<sub>V2-3</sub> adjusting for sex and sporting discipline.</p><p><strong>Results: </strong>Of 4423 athletes (40% female athletes; mean age, 19.7±4.5 years), isolated TWI<sub>V2-3</sub> was found in 36 athletes aged ≥16 years (27 [1.5%] female athletes, 9 [0.3%] male athletes). Isolated TWI<sub>V2-3</sub> was more common in female athletes compared with male athletes (adjusted odds ratio, 4.2 [95% CI, 2.0-9.5]) and endurance compared with nonendurance athletes (adjusted odds ratio, 4.8 [95% CI, 2.5-9.5]). Follow-up investigations were available in 34 of 36, including echocardiogram (n=30), magnetic resonance imaging (n=3), stress ECG (n=2), or subsequent normal ECG (n=13). After 6.4±2.6 years of follow-up, no athletes with isolated TWI<sub>V2-3</sub> were diagnosed with cardiac disease. Overall, female athletes had a higher proportion of abnormal ECGs compared with male athletes (4.2% versus 2.6%, <i>P</i>=0.004). If TWI<sub>V2-3</sub> was considered a normal finding in female athletes, female and male athletes would have similar proportions of abnormal ECGs (2.6% versus 2.6%, <i>P</i>=0.95).</p><p><strong>Conclusions: </strong>Isolated TWI<sub>V2-3</sub> was 4 times more common in female athletes and 5 times more common in endurance athletes. This finding was not associated with cardiac pathology.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e042435"},"PeriodicalIF":5.3000,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Isolated Anterior T-Wave Inversion in Elite Athletes: Prevalence and Clinical Relevance by Sex and Sporting Discipline.\",\"authors\":\"Jessica J Orchard, Jonathan A Drezner, Hariharan Raju, Rajesh Puranik, Belinda Gray, Maria Brosnan, Robert N Doughty, Bruce Hamilton, Tim Driscoll, Angus J Davis, Emma Buckthorpe, Simon Eggleton, Aaron Baggish, Andre La Gerche, John W Orchard\",\"doi\":\"10.1161/JAHA.125.042435\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Cardiac screening of elite athletes is common internationally. Female athletes are reported to have a higher proportion of abnormal screening ECGs compared with male athletes, despite lower rates of sudden cardiac death. T-wave inversion in leads V<sub>2</sub> and V<sub>3</sub> (TWI<sub>V2-3</sub>) is considered abnormal for athletes aged ≥16 years, but there are knowledge gaps in prevalence and clinical outcomes.</p><p><strong>Methods: </strong>Data were obtained from the ARENA (Australasian Registry of ECGs of National Athletes) project and combined with previous athlete cohort studies from Australia and New Zealand. Sporting disciplines included Olympic sports (summer and winter), Australian football, cricket, football (soccer), and netball. Logistic regression calculated adjusted odds ratios with 95% CIs for the odds of isolated TWI<sub>V2-3</sub> adjusting for sex and sporting discipline.</p><p><strong>Results: </strong>Of 4423 athletes (40% female athletes; mean age, 19.7±4.5 years), isolated TWI<sub>V2-3</sub> was found in 36 athletes aged ≥16 years (27 [1.5%] female athletes, 9 [0.3%] male athletes). Isolated TWI<sub>V2-3</sub> was more common in female athletes compared with male athletes (adjusted odds ratio, 4.2 [95% CI, 2.0-9.5]) and endurance compared with nonendurance athletes (adjusted odds ratio, 4.8 [95% CI, 2.5-9.5]). Follow-up investigations were available in 34 of 36, including echocardiogram (n=30), magnetic resonance imaging (n=3), stress ECG (n=2), or subsequent normal ECG (n=13). After 6.4±2.6 years of follow-up, no athletes with isolated TWI<sub>V2-3</sub> were diagnosed with cardiac disease. Overall, female athletes had a higher proportion of abnormal ECGs compared with male athletes (4.2% versus 2.6%, <i>P</i>=0.004). If TWI<sub>V2-3</sub> was considered a normal finding in female athletes, female and male athletes would have similar proportions of abnormal ECGs (2.6% versus 2.6%, <i>P</i>=0.95).</p><p><strong>Conclusions: </strong>Isolated TWI<sub>V2-3</sub> was 4 times more common in female athletes and 5 times more common in endurance athletes. This finding was not associated with cardiac pathology.</p>\",\"PeriodicalId\":54370,\"journal\":{\"name\":\"Journal of the American Heart Association\",\"volume\":\" \",\"pages\":\"e042435\"},\"PeriodicalIF\":5.3000,\"publicationDate\":\"2025-10-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of the American Heart Association\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1161/JAHA.125.042435\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/9/30 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the American Heart Association","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1161/JAHA.125.042435","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/9/30 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Isolated Anterior T-Wave Inversion in Elite Athletes: Prevalence and Clinical Relevance by Sex and Sporting Discipline.
Background: Cardiac screening of elite athletes is common internationally. Female athletes are reported to have a higher proportion of abnormal screening ECGs compared with male athletes, despite lower rates of sudden cardiac death. T-wave inversion in leads V2 and V3 (TWIV2-3) is considered abnormal for athletes aged ≥16 years, but there are knowledge gaps in prevalence and clinical outcomes.
Methods: Data were obtained from the ARENA (Australasian Registry of ECGs of National Athletes) project and combined with previous athlete cohort studies from Australia and New Zealand. Sporting disciplines included Olympic sports (summer and winter), Australian football, cricket, football (soccer), and netball. Logistic regression calculated adjusted odds ratios with 95% CIs for the odds of isolated TWIV2-3 adjusting for sex and sporting discipline.
Results: Of 4423 athletes (40% female athletes; mean age, 19.7±4.5 years), isolated TWIV2-3 was found in 36 athletes aged ≥16 years (27 [1.5%] female athletes, 9 [0.3%] male athletes). Isolated TWIV2-3 was more common in female athletes compared with male athletes (adjusted odds ratio, 4.2 [95% CI, 2.0-9.5]) and endurance compared with nonendurance athletes (adjusted odds ratio, 4.8 [95% CI, 2.5-9.5]). Follow-up investigations were available in 34 of 36, including echocardiogram (n=30), magnetic resonance imaging (n=3), stress ECG (n=2), or subsequent normal ECG (n=13). After 6.4±2.6 years of follow-up, no athletes with isolated TWIV2-3 were diagnosed with cardiac disease. Overall, female athletes had a higher proportion of abnormal ECGs compared with male athletes (4.2% versus 2.6%, P=0.004). If TWIV2-3 was considered a normal finding in female athletes, female and male athletes would have similar proportions of abnormal ECGs (2.6% versus 2.6%, P=0.95).
Conclusions: Isolated TWIV2-3 was 4 times more common in female athletes and 5 times more common in endurance athletes. This finding was not associated with cardiac pathology.
期刊介绍：
As an Open Access journal, JAHA - Journal of the American Heart Association is rapidly and freely available, accelerating the translation of strong science into effective practice.
JAHA is an authoritative, peer-reviewed Open Access journal focusing on cardiovascular and cerebrovascular disease. JAHA provides a global forum for basic and clinical research and timely reviews on cardiovascular disease and stroke. As an Open Access journal, its content is free on publication to read, download, and share, accelerating the translation of strong science into effective practice.
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