어린선수와 훈련받지않은 대상의 심전도상의 특성의 비교 = Comparison of the Electrocardiographic Characteristics of Junior Athletes and Untrained Subjects

다국어 초록 (Multilingual Abstract)

The hearts of highly trained athletes show morphologic and electrocardiographic (ECG) changes that suggest the presence of cardiovascular disease, including sinus bradycardia, a striking increase in precordial R-wave or S-wave voltages, ST segment depression, and T-wave inversions. Despite a number of previous observational surveys, the determinants of abnormal ECG patterns in trained athletes remain largely unresolved. In this study, we compared the electrocardiographic characteristics of athletes to determine any sensitive indicators. Comparison between ECG patterns and cardiac physiology was performed in 21 junior athletes and 25 untrained subjects with no signs of cardiac disease. Sinus bradycardia was detected in a subset of athletes but not statistically significant between the athletes (69.9±11.1 bpm) and the control (72.7±9.9 bpm) group.The mean values of the PR and QTc intervals in the athletes’ group were 149.2±15.4 ms and 402.3±28.8 ms, respectively. Also, there were no significantly differences between control group and the athletes’ group. In addition, the athletes demonstrated a spectrum of alterations in the 12-lead ECG pattern, including marked increase in precordial R-wave or S-wave voltages (SV1+RV5 ≧ 35 mm, 23.8%), QRS duration (≧ 90 ms, 90.5%), suggestive of left ventricular hypertrophy. However, left axis deviation, ST segment depression, and T-wave changes in V5, V6 were not observed in either the athletes or control group. Our findings suggest that sinus bradycardia, precordial R-wave or Swave voltages, and QRS duration seem to be more sensitively detected in athletes than in control group. Further researches on the electrocardiographic patterns of athletes should be carried out to improve the sensitivity and specificity of diagnostic criteria.

다국어 초록 (Multilingual Abstract)

.The hearts of highly trained athletes show morphologic and electrocardiographic (ECG) changes that suggest the presence of cardiovascular disease, including sinus bradycardia, a striking increase in precordial R-wave or S-wave voltages, ST segment depression, and T-wave inversions. Despite a number of previous observational surveys, the determinants of abnormal ECG patterns in trained athletes remain largely unresolved. In this study, we compared the electrocardiographic characteristics of athletes to determine any sensitive indicators. Comparison between ECG patterns and cardiac physiology was performed in 21 junior athletes and 25 untrained subjects with no signs of cardiac disease. Sinus bradycardia was detected in a subset of athletes but not statistically significant between the athletes (69.9±11.1 bpm) and the control (72.7±9.9 bpm) group.The mean values of the PR and QTc intervals in the athletes’ group were 149.2±15.4 ms and 402.3±28.8 ms, respectively. Also, there were no significantly differences between control group and the athletes’ group. In addition, the athletes demonstrated a spectrum of alterations in the 12-lead ECG pattern, including marked increase in precordial R-wave or S-wave voltages (SV1+RV5 ≧ 35 mm, 23.8%), QRS duration (≧ 90 ms, 90.5%), suggestive of left ventricular hypertrophy. However, left axis deviation, ST segment depression, and T-wave changes in V5, V6 were not observed in either the athletes or control group. Our findings suggest that sinus bradycardia, precordial R-wave or Swave voltages, and QRS duration seem to be more sensitively detected in athletes than in control group. Further researches on the electrocardiographic patterns of athletes should be carried out to improve the sensitivity and specificity of diagnostic criteria.

참고문헌 (Reference)

1 Pelliccia A, 28 (28): 2006-2010, 2007

2 김영주, "중년남성의 운동유형의 적응이 좌심실 구조와 기능 및 심폐체력에 미치는 영향" 한국사회체육학회 (34) : 1073-1082, 2008

3 박태열, "육상장거리선수의 심전도 파형에 관한 연구" 14 : 545-552, 2000

4 주기찬, "운동선수의 안정시 및 점증부하운동 중 심전도 양상" 한국운동생리학회 11 (11): 467-482, 2002

5 임인자, "엘리트 운동선수의 성별에 따른 안정시심전도 특성" 18 (18): 23-32, 2000

6 최지용, "수영선수에서 집중훈련이 심전도 및 운동능력에 미치는 영향" 21 (21): 1210-1218, 1991

7 우언조, "배구선수에서 집중훈련전후의 심전도 및 심초음파 도의 비교관찰" 22 (22): 939-946, 1992

8 Parker BM, "The noninvasive cardiac evaluation of long-distance runners" 73 (73): 376-381, 1978

9 Van Ganse W, "The electrocardiogram of athletes. comparison with untrained subjects" 32 (32): 160-164, 1970

10 Gott PH, "The athletic heart syndrome" 122 (122): 340-344, 1968

11 Naylor LH, "The athlete’s heart: a contemporary appraisal of the ‘Morganroth hypothesis’" 38 (38): 69-90, 2008

12 Rawlins J, "Left ventricular hypertrophy iin athletes" 10 (10): 350-356, 2009

13 Northcote RJ, "Electrocardiographic findings in male veteran endurance athletes" 61 (61): 155-160, 1989

14 Holly RG, "Electrocardiographic alterations associated with the hearts of athletes" 25 (25): 139-148, 1998

15 McMullen JR, "Differences between pathological and physiological cardiac hypertrophy: novel therapeutic strategies to treat heart failure" 34 (34): 255-262, 2007

16 Franklin BA, "Cardiovascular Evaluation of the Athlete-Issues Regarding Performance, Screening and Sudden Cardiac Death" 24 (24): 97-119, 1997

17 Pelliccia A, "Athlete’s heart electrocardiogram mimicking hypertrophic cardiomyopathy" 3 (3): 147-151, 2001