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Athletes with Abnormal ECGs Require Surveillance

Higher risk of cardiomyopathies and sudden cardiac death

WEDNESDAY, Jan. 9 (HealthDay News) -- Healthy athletes who have marked repolarization abnormalities on electrocardiogram (ECG) but no other signs of heart disease should be closely followed, as a small subgroup will go on to develop cardiomyopathies, researchers report in the Jan. 10 issue of the New England Journal of Medicine.

Antonio Pelliccia, M.D., of the Institute of Sports Medicine and Science, Italian National Olympic Committee in Rome, Italy, and colleagues used a national database of 12,550 trained athletes to identify 81 athletes with marked repolarization abnormalities on ECG but no clinical or echocardiographic evidence of heart disease. The researchers followed the athletes for a mean of nine years and compared outcomes to a matched control group of 229 athletes with normal ECGs.

During the follow-up period, five of the 81 athletes (6 percent) with abnormal ECGs developed cardiomyopathies. One athlete died suddenly at age 24 from an occult arrythmogenic right ventricular cardiomyopathy. Three individuals developed hypertrophic cardiomyopathy, of which one had an aborted cardiac arrest. The fifth athlete ultimately developed a dilated cardiomyopathy. In comparison, no athletes with normal ECGs developed a cardiomyopathy or had a cardiac event during the follow-up period.

"Markedly abnormal ECGs in young and apparently healthy athletes may represent the initial expression of underlying cardiomyopathies that may not be evident until many years later," Pelliccia and colleagues write. "Athletes with such ECG patterns merit continued clinical surveillance."

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