Abnormal ECG more common in female athletes vs. male athletes
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Abnormal ECG findings were more common in female athletes compared with male athletes, according to a study published in JAMA Cardiology.
“Exercise-induced cardiac remodeling is the process by which the cardiovascular system adapts to the hemodynamic stress imposed by athletic training,” Timothy W. Churchill, MD, cardiologist in the Cardiovascular Performance Program at Massachusetts General Hospital and instructor in medicine at Harvard Medical School, and colleagues wrote. “Accurate differentiation of benign exercise-induced cardiovascular adaptations from high-risk pathology ... underlies the successful clinical evaluation of symptomatic and asymptomatic athletes.”
The prospective, cross-sectional study included 238 U.S. soccer players (51% women; mean age, 20 years) aged 15 to 40 years. Researchers evaluated normal training-related ECG and abnormal ECG as well as echocardiographic measurements of structural and functional parameters relevant to CV remodeling.
Compared with male athletes, female athletes were more likely to have abnormal ECG patterns (0% vs. 11%, respectively). Echocardiography analysis revealed both female and male athletes frequently exceeded normal ranges for structural cardiac parameters, including body surface area-indexed left ventricular mass (51% in female athletes vs. 59% in male athletes), indexed LV volume (77% in female athletes vs. 68% in male athletes) and LV wall thickness (30% in female athletes vs. 41% in male athletes). Further analysis stratified by age demonstrated age-dependent increases in LV wall thickness and LV mass among both female and male athletes; female athletes also experienced increases in LV volumes. No pathological findings met criteria for sport restriction.
“Our data demonstrate a high prevalence of benign training-related ECG findings and identify several specific abnormal ECG patterns with suboptimal specificity for true underlying pathology. Similar to other cohorts of elite athletes, our data confirm an elevated prevalence of adaptative cardiac structural remodeling,” Churchill and colleagues concluded. “We anticipate that the data presented in this article will serve as a valuable reference during future clinical assessments of elite female and male soccer players.”
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