In a new study, 1 in 5 National Basketball Association athletes had abnormal ECG classifications, some of which may be influenced by left ventricular concentric remodeling.
Marc P. Waase, MD, PhD, electrophysiology fellow at NewYork-Presbyterian Hospital, and colleagues analyzed preseason ECG examinations of 519 NBA athletes. The mean age was 25 years and 79% were black. Participants were active-roster (n = 404) or predraft-combine athletes (n = 115). ECGs were performed in the 2013-2014 and 2014-2015 preseasons, in addition to the 2014 and 2015 predraft combine. Three athlete-specific interpretation criteria were used on each ECG: Seattle, refined and international.
Overall, 89% of athletes had at least one physiologic, training-related ECG change, and 63% had two or more changes. An abnormal ECG finding was observed in 25.2% of athletes using the Seattle criteria, 20.8% using the refined criteria and 15.6% using the international criteria.
Athletes aged 27 to 39 years were more likely to have ECG abnormalities compared with those aged 18 to 22 years (22.6% vs. 9.1%; OR = 2.9; 95% CI, 1.6-5.4).
Abnormal T-wave inversions, the most common abnormality in this athlete population, were observed in 6.2% of athletes and were linked to increased LV relative wall thickness and smaller LV cavity size. Athletes in the lowest LV relative wall thickness tertile were less likely to have abnormal T-wave inversions vs. those in the highest tertile (0.6% vs. 14.7%; OR = 29.5; 95% CI, 3.9-221).
“Continued work is required to understand the precise importance of the higher prevalence of repolarization abnormalities in this elite athlete population,” Waase and colleagues wrote in JAMA Cardiology.
Sanjay Sharma, MD, FRCP, professor of cardiology and lead for the inherited cardiomyopathies and sports cardiology unit at St. George’s, University of London, discussed the implications of these findings in a related editorial.
“The association of concentric left ventricular remodeling or hypertrophy with inferior and/or lateral [T-wave inversion] raises the question of whether left ventricular hypertrophy induced by sports in black athletes might be a harbinger for serious arrhythmias, as is the case in black patients with hypertensive heart disease,” Sharma wrote. “This point is pertinent because exercise-associated sudden cardiac death is much more common in (predominantly black) Division I male basketball players (who experienced one such death per 3,126 student-athletes per year) than in National College Athletic Association athletes overall (who had one sudden cardiac death per 43,770 student-athletes per year).” – by Darlene Dobkowski
Disclosures: Waase and Sharma report no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.