The electrocardiographic abnormalities in highly trained athletes compared to the genetic study related to causes of unexpected sudden cardiac death.

摘要: Background: Electrocardiograms in elite endurance athletes sometimes show bizarre patterns suggestive of inherited channelopathies (Brugada syndrome, long QTc, catecholaminergic polymorphic ventricular tachycardia) and cardiomyopathies (arrhythmogenic right cardiomyopathy, hypertrophic cardiomyopathy) responsible for unexpected sudden cardiac death. Among other methods, genetic analyses are required correct diagnosis. Objective: To correlate 12– lead electrocardiographic to specific analyses. Design: Prospective study (2004–2007) screening 12–lead ECG tracings standard position higher intercostal spaces V1 V3 precordial leads, performed normal sedentary subjects aged match. Genetic with abnormalities suggested cardiomyopathies. Setting: All cardiologic exams electrocardiograms were at ‘Prof. Dr. C.C. Iliescu’ National Institute Cardiovascular Diseases (Bucharest, Romania). The studies done ‘Mina Minovici’ Forensic Medicine Romania). Participants: 347 (seniors–190, juniors–157), mean age 20; 200 21, belonging the control group 505 population. Results: Seniors. RSR' (V1 V3) pattern, 45 cases (23.68%), 5 them questionable Brugada sign (elevated J wave ‘coved’ ST segment,< 2mm one lead, V1. Typically, 1 was found case (0.52%) no SCN5A abnormalities. One athlete had exon1 duplication. MRI confirmed three arrhythmic cardiomypathy epsilon waves (1.57%), case. ST–segment elevation myocardial injury like V1–V3 leads 34 (17.89%).Genetic analyses–no gene mutations. Juniors Upright 43 (27.38%). Convex segment V1–V3/V4, 39 (24.84%). Bifid T two distinct peaks (24.84%), mild prolonged QTc (0.48 ‘–0.56’) KCN genes Nine (5.73%) elevated juniors sign, which (n=1) Ajmaline provocative test negative 4 refused by subjects. Conclusion: Bizarre QRS, ST–T abnormal impulse conduction ventricle, including outflow tract, associated interval some observed highly trained athletes. analyses, most athletes, identified surprising mutations cases.