Open AccessVectorcardiogram in athletes: The Sun Valley Ski Study
Author(s) -
Thomas Jason A.,
A. PerezAlday Erick,
Junell Allison,
Newton Kelley,
Hamilton Christopher,
LiPershing Yin,
German David,
Bender Aron,
Tereshchenko Larisa G.
Publication year - 2019
Publication title -
annals of noninvasive electrocardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.494
H-Index - 48
eISSN - 1542-474X
pISSN - 1082-720X
DOI - 10.1111/anec.12614
Subject(s) - medicine , left ventricular hypertrophy , cardiology , vectorcardiography , qrs complex , athletes , prospective cohort study , muscle hypertrophy , sudden cardiac death , electrocardiography , physical therapy , blood pressure
Background Global electrical heterogeneity (GEH) is associated with sudden cardiac death (SCD) in adults of 45 years and above. However, GEH has not been previously measured in young athletes. The goal of this study was to establish a reference for vectorcardiograpic (VCG) metrics in male and female athletes. Methods Skiers ( n = 140; mean age 19.2 ± 3.5 years; 66% male, 94% white; 53% professional athletes) were enrolled in a prospective cohort. Resting 12‐lead ECGs were interpreted per the International ECG criteria. Associations of age, sex, and athletic performance with GEH were studied. Results In age and training level‐adjusted analyses, male sex was associated with a larger T vector [T peak magnitude +186 (95% CI 106–266) µV] and a wider spatial QRS‐T angle [+28.2 (17.3–39.2)°] as compared to women. Spatial QRS‐T angle in the ECG left ventricular hypertrophy (LVH) voltage group ( n = 21; 15%) and normal ECG group did not differ (67.7 ± 25.0 vs. 66.8 ± 28.2; p = 0.914), suggesting that ECG LVH voltage in athletes reflects physiological remodeling. In contrast, skiers with right ventricular hypertrophy (RVH) voltage ( n = 26, 18.6%) had wider QRS‐T angle (92.7 ± 29.6 vs. 66.8 ± 28.2°; p = 0.001), larger SAI QRST (194.9 ± 30.2 vs. 157.8 ± 42.6 mV × ms; p < 0.0001), but similar peak SVG vector magnitude (1976 ± 548 vs. 1939 ± 395 µV; p = 0.775) as compared to the normal ECG group. Better athletic performance was associated with the narrower QRS‐T angle. Each 10% worsening in an athlete's Federation Internationale de’ Ski downhill ranking percentile was associated with an increase in spatial QRS‐T angle by 2.1 (95% CI 0.3–3.9) degrees ( p = 0.013). Conclusion Vectorcardiograpic adds nuances to ECG phenomena in athletes.