Filippo M Quattrini1, Antonio Pelliccia2, Riccardo Assorgi1, Fernando M DiPaolo1, Maria Rosaria Squeo1, Franco Culasso3, Vincenzo Castelli4, Mark S Link5, Barry J Maron6. 1. Institute of Sport Medicine and Science, Italian National Olympic Committee, Rome, Italy. 2. Institute of Sport Medicine and Science, Italian National Olympic Committee, Rome, Italy. Electronic address: ant.pelliccia@libero.it. 3. Department of Experimental Medicine, University La Sapienza, Rome, Italy. 4. Giorgio Castelli Onluss Foundation, Rome, Italy. 5. Tufts Medical Center, Boston, Massachusetts. 6. Hypertrophic Cardiomyopathy Center, Minneapolis Heart Institute Foundation, Minneapolis. Minnesota.
Abstract
BACKGROUND: J wave/QRS slurring (early repolarization) on 12-lead ECG has been associated with increased risk for ventricular fibrillation in the absence of cardiovascular (CV) disease. OBJECTIVE: The purpose of this study was to assess the prevalence and clinical significance of J wave/QRS slurring in a large population of competitive athletes. METHODS: Seven hundred four athletes (436 males [62%], age 25 ± 5 years) free of CV disease who had engaged in 30 different sports were examined. Serial clinical, ECG, and echocardiographic evaluations were available over 1 to 18 years of follow-up (mean 6 ± 4 years). RESULTS: J wave was found in 102 athletes (14%) and was associated with QRS slurring in 32 (4%). It was found most commonly in anterior, lateral, and inferior leads (n = 73 [72%]), occasionally in lateral leads (n = 26 [25%]), and rarely in inferior leads (n = 3 [3%]). Most of 102 athletes (n = 86 [84%]) also showed ST-segment elevation. J wave/QRS slurring was associated with other training-related ECG changes (ie, increased R/S-wave voltages in 76%) and left ventricular (LV) morphologic remodeling (LV mass 199 ± 48 g vs 188 ± 56 g, P <.05). During follow-up, no athlete with J wave experienced cardiac event or ventricular tachyarrhythmias, or developed structural CV disease. CONCLUSION: In athletes, early repolarization pattern usually is associated with other ECG changes, such as increased QRS voltages and ST-segment elevation, as well as LV remodeling, suggesting that it likely represents another benign expression of the physiologic athlete's heart. J wave (early repolarization) is common in highly trained athletes and does not convey risk for adverse cardiac events, including sudden death or tachyarrhythmias.
BACKGROUND: J wave/QRS slurring (early repolarization) on 12-lead ECG has been associated with increased risk for ventricular fibrillation in the absence of cardiovascular (CV) disease. OBJECTIVE: The purpose of this study was to assess the prevalence and clinical significance of J wave/QRS slurring in a large population of competitive athletes. METHODS: Seven hundred four athletes (436 males [62%], age 25 ± 5 years) free of CV disease who had engaged in 30 different sports were examined. Serial clinical, ECG, and echocardiographic evaluations were available over 1 to 18 years of follow-up (mean 6 ± 4 years). RESULTS: J wave was found in 102 athletes (14%) and was associated with QRS slurring in 32 (4%). It was found most commonly in anterior, lateral, and inferior leads (n = 73 [72%]), occasionally in lateral leads (n = 26 [25%]), and rarely in inferior leads (n = 3 [3%]). Most of 102 athletes (n = 86 [84%]) also showed ST-segment elevation. J wave/QRS slurring was associated with other training-related ECG changes (ie, increased R/S-wave voltages in 76%) and left ventricular (LV) morphologic remodeling (LV mass 199 ± 48 g vs 188 ± 56 g, P <.05). During follow-up, no athlete with J wave experienced cardiac event or ventricular tachyarrhythmias, or developed structural CV disease. CONCLUSION: In athletes, early repolarization pattern usually is associated with other ECG changes, such as increased QRS voltages and ST-segment elevation, as well as LV remodeling, suggesting that it likely represents another benign expression of the physiologic athlete's heart. J wave (early repolarization) is common in highly trained athletes and does not convey risk for adverse cardiac events, including sudden death or tachyarrhythmias.
Authors: Wibke Reinhard; Teresa Trenkwalder; Bernhard Haller; Christine Meindl; Julia Schoenfeld; Bernhard M Kaess; Christian Hengstenberg; Heribert Schunkert; Axel Pressler; Martin Halle; Johannes Scherr Journal: Ann Noninvasive Electrocardiol Date: 2018-11-14 Impact factor: 1.468
Authors: Wesley T O'Neal; Yi Grace Wang; Hau-Tieng Wu; Zhu-Ming Zhang; Yabing Li; Larisa G Tereshchenko; E Harvey Estes; Ingrid Daubechies; Elsayed Z Soliman Journal: Am J Cardiol Date: 2016-08-20 Impact factor: 2.778
Authors: Shreyas Yakkali; Sneha Teresa Selvin; Sonu Thomas; Viktoriya Bikeyeva; Ahmed Abdullah; Aleksandra Radivojevic; Anas A Abu Jad; Anvesh Ravanavena; Chetna Ravindra; Emmanuelar O Igweonu-Nwakile; Safina Ali; Salomi Paul; Pousette Hamid Journal: Cureus Date: 2022-07-13