title: Diagnostic accuracy of extended-length electrocardiogram in differentiating between athlete's heart and hypertrophic cardiomyopathy.
abstract: BACKGROUND
  Standard 12-lead electrocardiogram (ECG) has several limitations in solving the differential diagnosis between physiologic left ventricular hypertrophy (PLVH) and hypertrophic cardiomyopathy (HCM), given the high rate of false-positive results in athletes. The aim of this study was to assess the usefulness of several arrhythmic risk indexes in differentiating PLVH from HCM.
  
  
  METHODS
  A multiparametric ECG analysis (extended-length ECG) was performed on 30 male athletes with PLVH and 30 male patients with HCM, with homogeneous age distribution.
  
  
  RESULTS
  The combination of 4 extended-length ECG variables, namely, corrected QT interval (Bazett), QT dispersion, mean resting heart rate, and low-amplitude signal duration at 25 Hz (low-amplitude signal duration at the end of filtered QRS) displayed remarkable diagnostic accuracy (area under receiver operating characteristic curve, 94%). The same accuracy was obtained replacing QT dispersion with T-wave complexity index.
  
  
  CONCLUSIONS
  Extended-length ECG can be considered an effective, low-cost, and low time-consuming clinical tool for distinguishing between PLVH and HCM.
authors: Sports Medicine Department, Careggi Hospital, University of Florence, Viale Morgagni 85, Florence, Italy. luigicaselli@msn.com
authors: Luigi
authors: L
authors: Caselli
authors: Giorgio
authors: G
authors: Galanti
authors: Luigi
authors: L
authors: Padeletti
authors: Michele
authors: M
authors: Nieri
authors: Franco
authors: F
authors: Cecchi
authors: Franco
authors: F
authors: Cipollini
authors: Massimo
authors: M
authors: Baldi
authors: Laura
authors: L
authors: Perrotta
authors: Simone
authors: S
authors: Vignini
authors: Antonio
authors: A
authors: Michelucci
mesh_terms: D000328:Adult; D000368:Aged; D056352:Athletes; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000379:methods*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity