title: Prevalence and determinants of the early repolarisation pattern in a group of young high endurance rowers.
abstract: BACKGROUND
  The prevalence and significance of the early repolarisation (ER) pattern in the general population has raised a number of questions. Even less data are available on athletes.
  
  
  OBJECTIVE
  To determine the prevalence and determinants of ER in a group of young high endurance athletes.
  
  
  METHODS
  We studied 117 rowers (46% women, mean age 17.5 ± 1.5 years, mean training duration 4.3 ± 1.8 years). On 12-lead electrocardiogram (ECG), we evaluated inferolateral leads for the presence of the ER pattern, defined as at least 0.1 mV elevation of the QRS-ST junction (J point) from the baseline in at least two leads. All subjects underwent detailed echocardiographic study, cardiopulmonary exercise test with evaluation of VO₂max (mean 57.1 ± 8.4 mL/kg/min), and evaluation of complete blood count and biometric parameters (fat tissue, body mass index, body surface area).
  
  
  RESULTS
  We identified 35 subjects with ER in the inferior and/or lateral leads. The phenomenon was more frequent in males (n = 25, 21.36% of the overall study population) than in females (n = 10, 8.54%, p = 0.01). The training duration in both groups (with or without ER) was similar (4.4 ± 1.5 vs. 4.3 ± 1.8 years, p > 0.05). Athletes with the ER pattern had significantly higher VO₂max (58.8 ± 7.8 vs. 55.3 ± 8.2 mL/kg/min, p = 0.03), lower resting heart rate (58.7 ± 11.3 vs. 65.4 ± 11.9 bpm, p < 0.01), higher haemoglobin level (15.2 ± 0.8 vs. 14.6 ± 1.2 g/dL, p < 0.01), higher red blood cell count (5.31 ± 0.3 vs. 4.98 ± 0.4 million/μL, p = 0.04), and lower fat tissue mass (12.1 ± 4.4 vs. 14.9 ± 6.0 kg, p < 0.01). Compared with the others, the ER group was characterised by a higher left atrial area index (12.2 ± 1.3 vs. 11.5 ± 1.6 cm²/m², p = 0.01), right atrial area index (9.9 ± 1.3 vs. 9.0 ± 1.4 cm²/m², p < 0.01), and right ventricular basal diameter index (2.0 ± 0.2 vs. 1.9 ± 0.2 cm/m², p = 0.04). We found no significant differences in any other cardiac size and function parameters.
  
  
  CONCLUSIONS
  ER pattern in the inferior and/or lateral leads is a frequent finding in the population of young high endurance rowers. The presence of ER pattern is associated with gender and a number of parameters reflecting the general level of fitness and may be considered an electrophysiological sign of the athlete's heart. The significance of these alterations should be evaluated in prospective follow-up studies.
authors.affiliation: Klinika Kardiologii, Nadciśnienia Tętniczego i Chorób Wewnętrznych; II Wydział Lekarski; Uniwersytet Medyczny w Warszawie. marcin.konopka@op.pl.
authors.forename: Marcin
authors.initials: M
authors.lastname: Konopka
authors.forename: Krystyna
authors.initials: K
authors.lastname: Burkhard-Jagodzińska
authors.forename: Krystyna
authors.initials: K
authors.lastname: Anioł-Strzyżewska
authors.forename: Wojciech
authors.initials: W
authors.lastname: Król
authors.forename: Andrzej
authors.initials: A
authors.lastname: Klusiewicz
authors.forename: Jolanta
authors.initials: J
authors.lastname: Chwalbińska
authors.forename: Andrzej
authors.initials: A
authors.lastname: Pokrywka
authors.forename: Dariusz
authors.initials: D
authors.lastname: Sitkowski
authors.forename: Mirosław
authors.initials: M
authors.lastname: Dłużniewski
authors.forename: Wojciech
authors.initials: W
authors.lastname: Braksator
mesh_terms: D000293:Adolescent; D056352:Athletes; D004562:Electrocardiography; D015444:Exercise; D005080:Exercise Test; D005260:Female; D006321:Heart / Q000033:anatomy & histology / Q000502:physiology*; D006801:Humans; D008297:Male; D010807:Physical Endurance; D011044:Poland; D012737:Sex Factors; D044465:White People; D055815:Young Adult
keywords: athlete’s heart; early repolarisation; young athletes