title: The athlete's heart in adolescent Africans: an electrocardiographic and echocardiographic study.
abstract: OBJECTIVE
  The goal of this study was to define electrocardiographic (ECG) and echocardiographic characteristics of adolescent African athletes.
  
  
  BACKGROUND
  Recent observations in African athletes reported large prevalence of left ventricular (LV) hypertrophy and ECG abnormalities. No data, so far, exist for adolescent Africans, which comprise a growing proportion of competitive/professional athletes.
  
  
  METHODS
  The study included 154 soccer players participating at the 8th African Under-17 Championship of 2009, representing Algeria, Burkina Faso, Cameroon, Gambia, Guinea, Malawi, Nigeria, and Zimbabwe. For comparison, 62 Italian players with similar ages, sport achievements, and training schedules were included.
  
  
  RESULTS
  African athletes showed higher R5/S1-wave voltages than Caucasian athletes (48.6 ± 12.1 mm vs. 34.1 ± 8.9 mm; p < 0.01), larger prevalence of ECG LV hypertrophy (89% vs. 42%; p < 0.001), ST-segment elevation (91% vs. 56%; p < 0.001), and deeply inverted, or diffusely flat/biphasic, T waves (14% vs. 3% [p < 0.05] and 25% vs. 8% [p < 0.008], respectively). LV wall thicknesses were increased in Africans by 5% compared with Caucasians, and exceeded normal limits (≥13 mm) in 4 Africans but in no Caucasians. No athlete showed evidence of cardiomyopathies (i.e., hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy). On individual analysis, Algerians showed lower R/S-wave voltages compared with other African athletes. Increased wall thickness (≥13 mm) was observed only in sub-Saharian athletes (from Burkina Faso, Cameroon, and Niger).
  
  
  CONCLUSIONS
  African athletes displayed large proportion of ECG abnormalities, including a striking increase in R/S-wave voltage, ST-segment elevation, and deeply inverted or diffusely flat T waves by adolescence. LV remodeling in African athletes was characterized by a disproportionate wall thickening than in Caucasians but similar cavity size. Finally, distinctive peculiarities existed in African athletes according to the country (and ethnic) origin.
authors.affiliation: Institute of Sport Medicine and Science, CONI, Rome, Italy.
authors.forename: Fernando M
authors.initials: FM
authors.lastname: Di Paolo
authors.forename: Christian
authors.initials: C
authors.lastname: Schmied
authors.forename: Yacine A
authors.initials: YA
authors.lastname: Zerguini
authors.forename: Astrid
authors.initials: A
authors.lastname: Junge
authors.forename: Filippo
authors.initials: F
authors.lastname: Quattrini
authors.forename: Franco
authors.initials: F
authors.lastname: Culasso
authors.forename: Jiri
authors.initials: J
authors.lastname: Dvorak
authors.forename: Antonio
authors.initials: A
authors.lastname: Pelliccia
mesh_terms: D000293:Adolescent; D000349:Africa; D056352:Athletes / Q000706:statistics & numerical data*; D044383:Black People / Q000706:statistics & numerical data*; D004452:Echocardiography; D004562:Electrocardiography; D006321:Heart / Q000502:physiology*; D006801:Humans; D008297:Male; D012916:Soccer