Role of the electrocardiogram in differentiating genetically determined dilated cardiomyopathy from athlete's heart
© 2022 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd..
BACKGROUND: Physiological cardiac remodelling in highly trained athletes may overlap with dilated cardiomyopathy (DCM).
OBJECTIVES: The aim of this study was to investigate the role of the electrocardiogram (ECG) in differentiating between physiological and pathological remodelling.
METHODS: The study population consisted of 30 patients with DCM who revealed a pathogenic variant at genetic testing and 30 elite athletes with significant cardiac remodelling defined by a left ventricular (LV) end-diastolic diameter >62 mm and/or LV ejection fraction between 45% and 50%.
RESULTS: The ECG was abnormal in 22 (73%) patients with DCM. The most common abnormalities were low voltages (n = 14, 47%), lateral T-wave inversion (TWI) (n = 6, 20%), ventricular ectopic beats (n = 5, 17%) and anterior TWI (n = 4, 13). Two athletes revealed an abnormal ECG: complete left bundle branch block (LBBB) in one case and atrial flutter in the other. The sensitivity, specificity and accuracy of the ECG in differentiating DCM from physiological adaptation to exercise in athletes was 73% (confidence interval [CI]: 54%-88%), 93% (CI: 78%-99%) and 0.83 (CI: 0.71-0.92) respectively.
CONCLUSIONS: While the ECG is usually normal in athletes exhibiting significant LV dilatation and/or systolic dysfunction, this test is often abnormal in patients with DCM harbouring a pathogenic variant. Low voltages in the limb leads and lateral TWI are the most common abnormalities.
| Errataetall: |
CommentIn: Eur J Clin Invest. 2022 Oct;52(10):e13844. - PMID 35917223 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:52 |
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| Enthalten in: |
European journal of clinical investigation - 52(2022), 10 vom: 18. Okt., Seite e13837 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Zaffalon, Denise [VerfasserIn] |
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| Links: |
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| Themen: |
Athlete's heart |
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| Anmerkungen: |
Date Completed 14.09.2022 Date Revised 20.10.2022 published: Print-Electronic CommentIn: Eur J Clin Invest. 2022 Oct;52(10):e13844. - PMID 35917223 Citation Status MEDLINE |
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| doi: |
10.1111/eci.13837 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM343692902 |
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| 245 | 1 | 0 | |a Role of the electrocardiogram in differentiating genetically determined dilated cardiomyopathy from athlete's heart |
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| 500 | |a Date Revised 20.10.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: Eur J Clin Invest. 2022 Oct;52(10):e13844. - PMID 35917223 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2022 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd. | ||
| 520 | |a BACKGROUND: Physiological cardiac remodelling in highly trained athletes may overlap with dilated cardiomyopathy (DCM) | ||
| 520 | |a OBJECTIVES: The aim of this study was to investigate the role of the electrocardiogram (ECG) in differentiating between physiological and pathological remodelling | ||
| 520 | |a METHODS: The study population consisted of 30 patients with DCM who revealed a pathogenic variant at genetic testing and 30 elite athletes with significant cardiac remodelling defined by a left ventricular (LV) end-diastolic diameter >62 mm and/or LV ejection fraction between 45% and 50% | ||
| 520 | |a RESULTS: The ECG was abnormal in 22 (73%) patients with DCM. The most common abnormalities were low voltages (n = 14, 47%), lateral T-wave inversion (TWI) (n = 6, 20%), ventricular ectopic beats (n = 5, 17%) and anterior TWI (n = 4, 13). Two athletes revealed an abnormal ECG: complete left bundle branch block (LBBB) in one case and atrial flutter in the other. The sensitivity, specificity and accuracy of the ECG in differentiating DCM from physiological adaptation to exercise in athletes was 73% (confidence interval [CI]: 54%-88%), 93% (CI: 78%-99%) and 0.83 (CI: 0.71-0.92) respectively | ||
| 520 | |a CONCLUSIONS: While the ECG is usually normal in athletes exhibiting significant LV dilatation and/or systolic dysfunction, this test is often abnormal in patients with DCM harbouring a pathogenic variant. Low voltages in the limb leads and lateral TWI are the most common abnormalities | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a athlete's heart | |
| 650 | 4 | |a dilated cardiomyopathy | |
| 650 | 4 | |a electrocardiogram | |
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| 700 | 1 | |a Merghani, Ahmed |e verfasserin |4 aut | |
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| 700 | 1 | |a Moccia, Eleonora |e verfasserin |4 aut | |
| 700 | 1 | |a Malhotra, Aneil |e verfasserin |4 aut | |
| 700 | 1 | |a Miles, Christopher J |e verfasserin |4 aut | |
| 700 | 1 | |a Attard, Virginia |e verfasserin |4 aut | |
| 700 | 1 | |a Homfray, Tessa |e verfasserin |4 aut | |
| 700 | 1 | |a Sharma, Rajan |e verfasserin |4 aut | |
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| 700 | 1 | |a Finocchiaro, Gherardo |e verfasserin |4 aut | |
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