Study of ECG findings among WNBA athletes could guide future screening programs
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Key takeaways:
- Abnormal ECG findings were rare in elite female basketball players.
- These data may serve as a reference for basketball screening programs and clinicians screening female athletes.
Training-related ECG findings were common and abnormal ECG findings were rare among Women’s National Basketball Association athletes, researchers reported.
The findings may serve as reference for future screening programs of female athletes, according to a brief report published in JAMA Cardiology.
“Despite available echocardiographic reference data for National Basketball Association (NBA) and Women’s National Basketball Association (WNBA) athletes and ECG reference data for NBA athletes, the spectrum of ECG findings in professional female basketball athletes has not been described,” Bradley S. Lander, MD, a cardiologist at University Hospitals Harrington Heart and Vascular Institute, Case Western Reserve University School of Medicine, and colleagues wrote. “As such, characterizing the ECG profiles of professional female basketball athletes is important, given their propensity to develop significant cardiac remodeling and the growing use of ECGs in large-scale screening programs for female athletes.”
The WNBA mandated for all athletes annual preseason ECG and echocardiogram screening, for which core laboratory analysis was conducted at Columbia University Irving Medical Center. Lander and colleagues evaluated data collected from April to May 2022 to identify training-related and abnormal findings using the International Recommendations for Electrocardiographic Interpretation in Athletes.
The study consisted of 173 female athletes (mean age, 27 years; 75% Black).
Overall, 78.6% of participants had training-related ECG changes and 4.6% had abnormal ECG findings.
Among athletes with at least one training-related ECG finding, left ventricular structural adaptations were present in 47.1%. Other common training-related ECG changes included sinus bradycardia in 61.3%, early repolarization in 24.3%, LV hypertrophy in 10.4% and a PR interval of 200 milliseconds or more in 10.3%.
Convex ST elevations and concomitant T-wave inversions in leads V1 to V4 were present in 6.9% of participants, all of whom were Black.
Among athletes with at least one training-related ECG finding, 47.1% demonstrated increased LV end-diastolic diameter on echocardiography, increased LV mass index or increased relative wall thickness.
The researchers did not report observing any association between presence of a training-related ECG finding and indices of athletic remodeling, when analyzed individually.
Increased relative wall thickness was more prevalent in athletes with the repolarization variant demonstrating convex ST elevation and concomitant T-wave inversions in leads V1 to V4 (50%) compared with athletes with early repolarization (11.9%; OR = 7.4; 95% CI, 1.71-32.09; P = .01).
Moreover, abnormal ECG findings included T-wave inversions in three athletes (1.7%), Q waves in two (1.2%), prolonged QTc interval in two (1.2%) and frequent premature ventricular contractions in one (0.6%), according to the study.
“This cross-sectional study provides reference ECG data for elite female basketball athletes and has direct applicability to female basketball programs that use or are considering using ECGs as part of a screening protocol, and to health care professionals caring for female basketball athletes,” the researchers wrote. “These data may be used as reference and stimulus for future female-specific and sport-specific ECG inquiries.”
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