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The juvenile ECG pattern in adolescent athletes and non-athletes in a national cardiac screening program (BEAT-IT).

Authors :
Abela M
Yamagata K
Buttigieg L
Xuereb S
Bonello J
Soler JF
Camilleri W
Grech N
Xuereb R
Sapiano K
Abela E
Callus A
Farrugia M
Felice T
Burg M
Sammut M
Xuereb RG
Grech V
Source :
International journal of cardiology [Int J Cardiol] 2023 Jan 15; Vol. 371, pp. 508-515. Date of Electronic Publication: 2022 Sep 07.
Publication Year :
2023

Abstract

Background: Anterior T wave inversion (TWI) is frequent in healthy adolescent individuals (juvenile ECG pattern), normalising after puberty. Its clinical implications are uncertain.<br />Aim: This study assessed a) national prevalence of anterior TWI, b) ST segment morphology, c) proportion of individuals with a juvenile ECG pattern whose ECG normalises and d) factors predicting TWI persistence >16 years.<br />Methods: Adolescents (mean 15y) in Malta were systematically invited to enrol in a cardiac screening program. Subjects completed a health questionnaire and an ECG at their school. Participants with TWI were labelled as TWI in V <subscript>1</subscript> -V <subscript>2</subscript> or extended TWI (V <subscript>1</subscript> -V <subscript>3</subscript> / <subscript>4</subscript> ). The latter were followed at 1 year with a repeat ECG. Those with persistent extended anterior TWI were offered evaluation and surveillance.<br />Results: The prevalence of isolated anterior TWI was 5.0%, commoner in females (6.3%) independent of athletic ability. Extended TWI was commoner in female athletes (4.2%, non-athletes 2.1%). Females often had shallow TWI without overt ST segment abnormalities. Deep TWI and ST segment changes were more frequent in males. Only 0.2% of cases persisted ≥16 years of age. ST segment characteristics were not able to predict T wave normalisation. No events took place during follow up (40 ± 9 months).<br />Conclusion: Anterior TWI is a frequent phenomenon in adolescents, especially in females. Female athletes are also more likely to have extended anterior TWI. Only 0.2% of cases have persistent anterior TWI at 16 years of age. Chest wall anatomy may explain this phenomenon in females. It is uncommon in males, hence why surveillance is more prudent.<br />Competing Interests: Declaration of Competing Interest The authors report no relationships that could be construed as a conflict of interest.<br /> (Copyright © 2022 Elsevier B.V. All rights reserved.)

Details

Language :
English
ISSN :
1874-1754
Volume :
371
Database :
MEDLINE
Journal :
International journal of cardiology
Publication Type :
Academic Journal
Accession number :
36087635
Full Text :
https://doi.org/10.1016/j.ijcard.2022.09.005