Impact of the distance from the chest wall to the heart on surface ECG voltage in athletes.
athlete’s heart
electrocardiography
left ventricular hypertrophy
pre-participation evaluation
Journal
BMJ open sport & exercise medicine
ISSN: 2055-7647
Titre abrégé: BMJ Open Sport Exerc Med
Pays: England
ID NLM: 101681007
Informations de publication
Date de publication:
2020
2020
Historique:
accepted:
14
02
2020
entrez:
24
3
2020
pubmed:
24
3
2020
medline:
24
3
2020
Statut:
epublish
Résumé
Available ECG criteria for detection of left ventricular (LV) hypertrophy have been reported to have limited diagnostic capability. Our goal was to describe how the distance between the chest wall and the left ventricle determined by echocardiography affected the relationship between ECG voltage and LV mass (LVM) in athletes. We retrospectively evaluated digitised ECG data from college athletes undergoing routine echocardiography as part of their preparticipation evaluation. Along with LV mass and volume, we determined the chest wall-LV distance in the parasternal short-axis and long-axis views from two-dimensional transthoracic echocardiographic images and explored the relation with ECG QRS voltages in all leads, as well as summed voltages as included in six major ECG-LVH criteria. 239 athletes (43 women) were included (age 19±1 years). In men, greater LV-chest wall distance was associated with higher R-wave amplitudes in leads aVL and I (R=0.20 and R=0.25, both p<0.01), while in women greater distance was associated with higher R-amplitudes in V5 and V6 (R=0.42 and R=0.34, both p<0.01). In women, the chest wall-LV distance was the only variable independently (and positively) associated with R V5 voltage, while LVM, height and weight contributed to the relationship in men. The chest wall-LV distance was weakly associated with ECG voltage in athletes. Inconsistent associations in men and women imply different intrathoracic factors affecting impedance and conductance between sexes. This may help explain the poor relationship between QRS voltage and LVM in athletes.
Identifiants
pubmed: 32201618
doi: 10.1136/bmjsem-2019-000696
pii: bmjsem-2019-000696
pmc: PMC7061894
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e000696Informations de copyright
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: VF and DHa are developers and part-owners of the ECG system used to acquire the digitised ECG data (Cardea 20/20 ECG System, Cardic Insight, Bellevue, Washington, USA).
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