This article is more than 5 years old. Information may no longer be current.
Cardiac ECG anomalies common in younger patients
One in five people aged 35 years or younger demonstrate ECG patterns indicative of underlying cardiac disease, according to recent results.
However, although these findings suggest a potential need for nationwide screening for younger people, the potential for false-positive results and the cost of further testing call into question the feasibility of such an approach, the researchers wrote.
Researchers evaluated 7,764 nonathletes aged 14 to 35 years who underwent a 12-lead resting ECG and responded to a health questionnaire. ECG patterns were assessed according to European Society of Cardiology guidelines, and patterns related to athletic training (Group 1) were differentiated from those suggestive of underlying disease (Group 2). The results collected from the nonathletes were compared with those observed in a group of 4,081 athletes who underwent the same evaluation.
Among the nonathletes, 60.1% reported a relatively sedentary lifestyle (4 or fewer active hours per week). Athlete participants reported 15.7 hours of training per week across 24 sporting disciplines.
Researchers observed Group-1 ECG patterns in 49.1% of nonathletes vs. 87.4% of athletes (P<.001), and Group-2 patterns in 21.8% of nonathletes vs. 33% of athletes (P<.001). Among nonathletes, 52% of Group-2 patterns were QTc interval abnormalities, with 11% consisting of T-wave inversions.
Group-2 ECG anomalies were most prevalent among males in both athletes (35.7% vs. 22.3% among females) and nonathletes (25.9% vs. 11.7%; P<.001 for both). Black participants also were more prone to ECG abnormalities than white participants, regardless of athletic status (28.5% vs. 21.5% among nonathletes, P=.003; and 57.7% vs. 21.3% among athletes; P<.001). Group-2 ECG patterns also were more common among adults athletes vs. adolescent athletes (41% vs. 22.8%; P<.001).
Multivariable analysis indicated significant associations between Group-2 patterns and black ethnicity (OR=3.51; 95% CI, 3.09-4), male sex (OR=2.16; 95% CI, 1.86-2.51) and athlete status (OR=1.19; 95% CI, 1.06-1.33). Among nonathletes specifically, male sex (OR=2.88; 95% CI, 2.32-3.59) and black ethnicity (OR=2.39; 95% CI, 1.35-4.24) were most strongly associated with abnormal ECG patterns.
Based on these findings, the researchers wrote, more than 20% of young people would fail initial evaluations after an ECG and would require additional testing under current ESC criteria.
“The implications of the ensuing costs of further investigations on a financially constrained health budget in times of austerity would be insurmountable,” the researchers wrote. “… Further refinement of the criteria for Group-2 ECG patterns is required to improve the specificity of the ECG before any consideration can be can be given to nationwide population screening.”
Disclosure: The researchers report no relevant financial disclosures.