Diagnostic accuracy of extended-length electrocardiogram in differentiating between athlete's heart and hypertrophic cardiomyopathy.
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.
Caselli
Luigi
L
Sports Medicine Department, Careggi Hospital, University of Florence, Viale Morgagni 85, Florence, Italy. luigicaselli@msn.com
Galanti
Giorgio
G
Padeletti
Luigi
L
Nieri
Michele
M
Cecchi
Franco
F
Cipollini
Franco
F
Baldi
Massimo
M
Perrotta
Laura
L
Vignini
Simone
S
Michelucci
Antonio
A
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