title: Alterations in echocardiographic and electrocardiographic features in Japanese professional soccer players: comparison to African-Caucasian ethnicities.
abstract: BACKGROUND
  Scarce data are available regarding the electrocardiographic (ECG) and echocardiographic changes in athletes of Asian origin.
  
  
  METHODS
  We investigate the ECG and echocardiographic patterns in Japanese (J) compared with African-Caribbean (AC) and Caucasian (C) athletes.
  
  
  METHODS
  A total of 282 professional soccer players (68 J, 96 AC and 118 C) matched for age, gender, sport and level of achievement was examined.
  
  
  RESULTS
  ECGs were without alterations in 62% of J (versus 69% of C, p = non significant and 44% of AC, p < 0.001). The most common alterations in J were sinus bradycardia (69%), incomplete right bundle branch block (RBBB; 43%), early repolarization (18%), isolated increase in R/S-wave (10%), Q-waves (9%). Remarkably, no J athlete showed deeply T-wave inversion, in contrast to 6% of AC (p < 0.05). Occasionally, J showed J-point upward/domed ST-elevation with inverted/biphasic T-wave (6% versus 16.5% in AC, p < 0.01). J demonstrated larger left ventricular (LV) cavity compared with AC and C players (55.2 ± 3.3 versus 52.2 ± 3.8 and 53.9 ± 3.7 mm, respectively, p < 0.01), with an important subset ( > 4%) presenting a markedly enlarged cavity (>60 mm), in the presence of normal systolic/diastolic function and no segmental abnormalities. Therefore, J showed a more eccentric remodelling compared with AC and C (relative wall thickness: 0.31 ± 0.05, 0.38 ± 0.06 and 0.36 ± 0.06, respectively, p < 0.01).
  
  
  CONCLUSIONS
  J players show the most eccentric LV remodelling compared with C and AC players. In association, certain training-related ECG patterns, i.e. sinus bradycardia and isolated increase in R/S-wave voltage, are present in a larger proportion of J players than previously described in C players. Conversely, no J athlete showed deeply T-wave inversion, as commonly found in AC and occasionally in C.
authors.affiliation: INSERM, CIC-IT 804, Rennes, F-35000, France.
authors.forename: Gaëlle
authors.initials: G
authors.lastname: Kervio
authors.forename: Antonio
authors.initials: A
authors.lastname: Pelliccia
authors.forename: Junzo
authors.initials: J
authors.lastname: Nagashima
authors.forename: Mathew G
authors.initials: MG
authors.lastname: Wilson
authors.forename: Jean
authors.initials: J
authors.lastname: Gauthier
authors.forename: Masahiro
authors.initials: M
authors.lastname: Murayama
authors.forename: Laurent
authors.initials: L
authors.lastname: Uzan
authors.forename: Nathalie
authors.initials: N
authors.lastname: Ville
authors.forename: François
authors.initials: F
authors.lastname: Carré
mesh_terms: D000293:Adolescent; D000328:Adult; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000208:ethnology*; D044466:Asian People; D054874:Athletic Performance; D044383:Black People; D059267:Cardiomegaly, Exercise-Induced; D004452:Echocardiography; D004562:Electrocardiography; D005602:France / Q000453:epidemiology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D064797:Physical Conditioning, Human; D011237:Predictive Value of Tests; D012916:Soccer; D020257:Ventricular Remodeling; D044465:White People; D055815:Young Adult