RELATIONSHIP BETWEEN EARLY VENTRICULAR REPOLARIZATION WITH SIGNS OF MYOCARDIAL REMODELING IN PROFESSIONAL ATHLETES

Ataman Y. O., Korzh V. A., Gordina М. А., Moiseenko I. O., Radych К. М.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

The objective of the study was to analyze relationship between early ventricular repolarization with signs of myocardial remodeling in professional athletes. The study included 35 high-level competition athletes who had regular intensive physical activity for at least six months. Syndrome of early repolarization was diagnosed on the basis of ECG registration, in case of elevation of the J-point on 1 mm and more above the isoelectric line in the lower or lateral leads was detected. Diagnosis of cardiac hypertrophy was established by electrocardiography and echocardiography.Our findings indicate that early repolarization syndrome is quite common in athletes, regardless of gender or age. As well, its development is associated with the intensity of physical activity (the predominance of anaerobic exercises during training), ECG and EchoCG, signs of myocardial hypertrophy. We have not established a strong correlation between the height of the end point of the ventricular complex j and the percentage of anaerobic exercises in training, as well as the Sokolov-Lyon index. It was noticeable that for most athletes – 27 (77%), – the Cornell Voltage Index remained within the normal range. In our opinion, this finding is because the peculiarities of the topography of the heart and directly due to the remodeling of the myocardium, which, according to echocardiography, was uniform among the majority of surveyed people. Numerous data indicate that the development of hypertrophy in athletes has adaptive role and is one of the examples of physiological reactivity («adapted heart»). On the other hand, prolonged physical exertion can cause changes in the rhythm and conduction of the heart, dilatation of its chambers, and repolarization disorders. They require an individual approach to the interpretation of the data obtained, taking into account the results of other examinations and history. The relationship between early repolarization and ventricular myocardial hypertrophy may be more indicative for the common development of these heart features in athletes. Accordingly, we suggest that early ventricular repolarization is a sign of the «athletes heart» syndrome in professional athletes with a high level of physical activity. The questions remain, however, about the mechanisms of evolution of early ventricular repolarization, and its possible dynamics, what type and localization of hypertrophy is more common, and what future of these signs of «sports heart» after the cessation of intense sports activities. However, it should be noted, that the main focus for the study of the issues is need to find the prognostic value of repolarization disorders, since there is evidence pointing to its relationship with acute cardiac events. Therefore, further research is needed to cover these issues.

early repolarization syndrome, heart hypertrophy, athletes heart, professional athletes.

1. Schnohr P, O’Keefe JH, Marott JL, Lange P, Jensen JB. Dose of Jogging and Long-Term Mortality: The Copenhagen City Heart Study. J Am Coll Cardiol. 2015 Feb 10;65(5):411-9.
2. Sharma S, Merghani A, Mont L. Exercise and the heart: the good, the bad, and the ugly. Eur Heart J. 2015 Jun 14;36(23):1445-53.
3.  Montagnana M, Lippi G, Franchini M, Banfi G, Guidi GC. Sudden cardiac death in young athletes. Intern Med. 2008;47(15):1373-8.
4.  Panhuyzen-Goedkoop NM, Jorstad HT, Smeets JLRM. A new consensus document on electrocardiographic interpretation in athletes: does it help to prevent sudden cardiac death in athletes. Neth Heart J. 2018 Mar;26(3):127-32.
5. Haїssaguerre M, Derval N, Sacher F, Jesel L, Deisenhofer I, de Roy L, et al. Sudden cardiac arrest associated with early repolarization. N Engl J Med. 2008 May 8;358(19):2016-23.

«Bulletin of problems biology and medicine» Issue 2 Part 1 (150), 2019 year, 96-99 pages, index UDK 612.171.1:796.42

10.29254/2077-4214-2019-2-1-150-96-99