Nathan R Riding1, Sanjay Sharma2, Gavin McClean1,3, Carmen Adamuz4, Victoria Watt4, Mathew G Wilson1,3. 1. Athlete Health and Performance Research Centre, Aspetar Orthopaedic and Sports Medicine Hospital, Sports City Street, Doha, Qatar. 2. Cardiology Clinical and Academic Group, St George's, University of London, Cranmer Terrace, London, UK. 3. Research Institute for Sport and Exercise Science, Liverpool John Moores University, Tom Reilly Building, Liverpool, UK. 4. Department of Sports Medicine, Aspetar, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Sports City Street, Doha, Qatar.
Abstract
Aims: Black athletes demonstrate an increased prevalence of repolarization anomalies and left ventricular hypertrophy compared to their white counterparts. Recent international recommendations for electrocardiogram (ECG) interpretation in athletes now account for some of these observations, but little attention is given to whether the heart of the black athlete is universal, or whether substantial differences exist according to geographic origin. Our aim was to examine the impact of geographical origin upon the electrical-and structural manifestations of the black athlete's heart. Methods and results: A total of 1698 male competitive athletes participating in mixed sports presented at our organization for 12 lead-ECG led pre-participation screening, with 1222 athletes undergoing systematic echocardiography. Black athletes were categorized against United Nations defined geographical regions (North, East, Middle and West Africa, African American/Caribbean, South American, and West Asia) and compared with a cohort of non-black athletes who shared a close geographical boarder with Africa (South European White and Arabic North African). The prevalence of an abnormal ECG suggestive of cardiac pathology significantly varied by geographical origin. Repolarization abnormalities were significantly more common among West (6.4%) and Middle African (8.5%) athletes than East (1.5%) and North Africans (1.2%) (P < 0.05). Left ventricular hypertrophy was significantly more common among African-American/Caribbean (9.5%) and West African (5%) athletes than West Asian (0.8%), East African (0%), and North African (0%) athletes (P < 0.05). This result remained after accounting for body size. Conclusion: The collective term 'black' should not imply that the hearts of all black athletes are universally comparable. There is considerable variability in the cardiac electrical and structural remodelling response to exercise that appears to be dependent on geographic origin.
Aims: Black athletes demonstrate an increased prevalence of repolarization anomalies and left ventricular hypertrophy compared to their white counterparts. Recent international recommendations for electrocardiogram (ECG) interpretation in athletes now account for some of these observations, but little attention is given to whether the heart of the black athlete is universal, or whether substantial differences exist according to geographic origin. Our aim was to examine the impact of geographical origin upon the electrical-and structural manifestations of the black athlete's heart. Methods and results: A total of 1698 male competitive athletes participating in mixed sports presented at our organization for 12 lead-ECG led pre-participation screening, with 1222 athletes undergoing systematic echocardiography. Black athletes were categorized against United Nations defined geographical regions (North, East, Middle and West Africa, African American/Caribbean, South American, and West Asia) and compared with a cohort of non-black athletes who shared a close geographical boarder with Africa (South European White and Arabic North African). The prevalence of an abnormal ECG suggestive of cardiac pathology significantly varied by geographical origin. Repolarization abnormalities were significantly more common among West (6.4%) and Middle African (8.5%) athletes than East (1.5%) and North Africans (1.2%) (P < 0.05). Left ventricular hypertrophy was significantly more common among African-American/Caribbean (9.5%) and West African (5%) athletes than West Asian (0.8%), East African (0%), and North African (0%) athletes (P < 0.05). This result remained after accounting for body size. Conclusion: The collective term 'black' should not imply that the hearts of all black athletes are universally comparable. There is considerable variability in the cardiac electrical and structural remodelling response to exercise that appears to be dependent on geographic origin.
Authors: Jason V Tso; Casey G Turner; Chang Liu; Angelo Galante; Carla R Gilson; Craig Clark; Herman A Taylor; Arshed A Quyyumi; Aaron L Baggish; Jonathan H Kim Journal: Br J Sports Med Date: 2021-08-13 Impact factor: 18.473
Authors: Ruben De Bosscher; Christophe Dausin; Kristel Janssens; Jan Bogaert; Adrian Elliott; Olivier Ghekiere; Caroline M Van De Heyning; Prashanthan Sanders; Jonathan Kalman; Diane Fatkin; Lieven Herbots; Rik Willems; Hein Heidbuchel; André La Gerche; Guido Claessen Journal: BMJ Open Sport Exerc Med Date: 2022-03-18
Authors: Tee Joo Yeo; Mingchang Wang; Robert Grignani; James McKinney; Lay Pheng Koh; Frankie Hun Yau Tan; Gregory Chung Tsing Chan; Nigel Tay; Siew-Pang Chan; Chi-Hang Lee; David Oxborough; Aneil Malhotra; Sanjay Sharma; Arthur Mark Richards Journal: Front Cardiovasc Med Date: 2022-01-03