Background: T-wave inversion (TWI) is rare in athlete's heart but is a common manifestation in cardiomyopathies. Although TWI has been extensively investigated in adult athletes, the ability of this ECG pattern to distinguish between a physiological variant and a developing heart muscle disease in children is controversial. The aim of this longitudinal study was to establish the prevalence, changes and clinical significance of TWI in a large cohort of pre-adolescent athletes. Methods: 2227 children (mean age 12.3 ± 2.0 years) undergoing sports preparticipation screening were included. Children with TWI underwent yearly follow-up until the positivisation of TWI for a maximum follow-up of 4 years. Results: Among 2227 children, 358 (16%) had TWI. Children with TWI were younger (11.4 ± 2.1 vs. 12.5 ± 2.0 years, p < 0.0001) and had a lower BSA than children without TWI (p < 0.0001). 97% of children showed anterior TWI while only 3% had infero-lateral TWI. Anterior TWI became positive in 94% of children during the 4-year follow-up (p < 0.0001 vs. baseline) and the remaining 6% did not show abnormal clinical findings. Conversely, in the group of 9 children with infero-lateral TWI, only 1 showed normalisation during follow-up (p = 0.81) and 1 was found to have a cardiomyopathy. Conclusions: Anterior TWI is common in children and generally becomes positive by the age of 14 years. Conversely, infero-lateral TWI is rare, persistent and may be associated with structural heart disease. Therefore, infero-lateral TWI should not be interpreted as physiologically related to age, development or training and children with infero-lateral TWI should remain under strict clinical surveillance.
D'Ascenzi, F., Anselmi, F., Berti, B., Capitani, E., Chiti, C., Franchini, A., et al. (2019). Prevalence and significance of T-wave inversion in children practicing sport: A prospective, 4-year follow-up study. INTERNATIONAL JOURNAL OF CARDIOLOGY, 279, 100-104 [10.1016/j.ijcard.2018.09.069].
Prevalence and significance of T-wave inversion in children practicing sport: A prospective, 4-year follow-up study
D'Ascenzi, Flavio
;ANSELMI, FRANCESCA;BERTI, BEATRICE;FRANCHINI, ANDREA;Focardi, Marta;Bonifazi, Marco;Mondillo, Sergio
2019-01-01
Abstract
Background: T-wave inversion (TWI) is rare in athlete's heart but is a common manifestation in cardiomyopathies. Although TWI has been extensively investigated in adult athletes, the ability of this ECG pattern to distinguish between a physiological variant and a developing heart muscle disease in children is controversial. The aim of this longitudinal study was to establish the prevalence, changes and clinical significance of TWI in a large cohort of pre-adolescent athletes. Methods: 2227 children (mean age 12.3 ± 2.0 years) undergoing sports preparticipation screening were included. Children with TWI underwent yearly follow-up until the positivisation of TWI for a maximum follow-up of 4 years. Results: Among 2227 children, 358 (16%) had TWI. Children with TWI were younger (11.4 ± 2.1 vs. 12.5 ± 2.0 years, p < 0.0001) and had a lower BSA than children without TWI (p < 0.0001). 97% of children showed anterior TWI while only 3% had infero-lateral TWI. Anterior TWI became positive in 94% of children during the 4-year follow-up (p < 0.0001 vs. baseline) and the remaining 6% did not show abnormal clinical findings. Conversely, in the group of 9 children with infero-lateral TWI, only 1 showed normalisation during follow-up (p = 0.81) and 1 was found to have a cardiomyopathy. Conclusions: Anterior TWI is common in children and generally becomes positive by the age of 14 years. Conversely, infero-lateral TWI is rare, persistent and may be associated with structural heart disease. Therefore, infero-lateral TWI should not be interpreted as physiologically related to age, development or training and children with infero-lateral TWI should remain under strict clinical surveillance.File | Dimensione | Formato | |
---|---|---|---|
Prevalence-significance-Twave-D'Ascenzi-2019.pdf
non disponibili
Tipologia:
PDF editoriale
Licenza:
NON PUBBLICO - Accesso privato/ristretto
Dimensione
471.54 kB
Formato
Adobe PDF
|
471.54 kB | Adobe PDF | Visualizza/Apri Richiedi una copia |
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
https://hdl.handle.net/11365/1071098