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Erschienen in: Clinical Research in Cardiology 5/2024

15.08.2023 | Original Paper

Prevalence and prognosis of structural heart disease among athletes with negative T waves and normal transthoracic echocardiography

verfasst von: Edoardo Conte, Francesca Pizzamiglio, Maria Antonietta Dessanai, Gianluca Guarnieri, Valentina Ardizzone, Matteo Schillaci, Antonio Dello Russo, Michela Casella, Saima Mushtaq, Eleonora Melotti, Davide Marchetti, Valentina Volpato, Gabrile Drago, Carlo Gigante, Chiarella Sforza, Antonio L. Bartorelli, Mauro Pepi, Gianluca Pontone, Claudio Tondo, Daniele Andreini

Erschienen in: Clinical Research in Cardiology | Ausgabe 5/2024

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Abstract

Introduction

The aim of the present study was to evaluate the prevalence and prognosis of structural heart disease (SHD) among competitive athletes with negative T waves without pathological findings at transthoracic echocardiogram.

Methods

From a prospective register of 450 athletes consecutively evaluated during a second-level cardiological examination, we retrospectively identified all subjects with the following inclusion criteria: (1) not previously known cardiovascular disease; (2) negative T waves in leads other than V1–V2; (3) normal transthoracic echocardiogram. Patients underwent cardiac MRI and CT. The primary endpoint was the diagnosis of definite SHD after multimodality imaging evaluation. A follow-up was collected for a combined end-point of sudden death, resuscitated sudden cardiac death and hospitalization for any cardiovascular causes.

Results

A total of 55 competitive athletes were finally enrolled (50 males, 90%) with a mean age of 27.5 ± 14.1 years. Among the population enrolled 16 (29.1%) athletes had a final diagnosis of SHD. At multivariate analysis, only deep negative T waves remained statistically significant [OR (95% CI) 7.81 (1.24–49.08), p = 0.0285]. Contemporary identification of deep negative T waves and complex arrhythmias in the same patients appeared to have an incremental diagnostic value. No events were collected at 49.3 ± 12.3 months of follow-up.

Conclusions

In a cohort of athletes with negative T waves at ECG, cardiac MRI (and selected use of cardiac CT) enabled the identification of 16 (29.1%) subjects with SHD despite normal transthoracic echocardiography. Deep negative T waves and complex ventricular arrhythmias were the only clinical characteristic associated with SHD diagnosis.

Graphical abstract

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Metadaten
Titel
Prevalence and prognosis of structural heart disease among athletes with negative T waves and normal transthoracic echocardiography
verfasst von
Edoardo Conte
Francesca Pizzamiglio
Maria Antonietta Dessanai
Gianluca Guarnieri
Valentina Ardizzone
Matteo Schillaci
Antonio Dello Russo
Michela Casella
Saima Mushtaq
Eleonora Melotti
Davide Marchetti
Valentina Volpato
Gabrile Drago
Carlo Gigante
Chiarella Sforza
Antonio L. Bartorelli
Mauro Pepi
Gianluca Pontone
Claudio Tondo
Daniele Andreini
Publikationsdatum
15.08.2023
Verlag
Springer Berlin Heidelberg
Erschienen in
Clinical Research in Cardiology / Ausgabe 5/2024
Print ISSN: 1861-0684
Elektronische ISSN: 1861-0692
DOI
https://doi.org/10.1007/s00392-023-02282-5

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