AUTHOR=Yeo Tee Joo , Wang Mingchang , Grignani Robert , McKinney James , Koh Lay Pheng , Tan Frankie Hun Yau , Chan Gregory Chung Tsing , Tay Nigel , Chan Siew-Pang , Lee Chi-Hang , Oxborough David , Malhotra Aneil , Sharma Sanjay , Richards Arthur Mark
TITLE=Electrocardiographic and Echocardiographic Insights From a Prospective Registry of Asian Elite Athletes
JOURNAL=Frontiers in Cardiovascular Medicine
VOLUME=8
YEAR=2022
URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.799129
DOI=10.3389/fcvm.2021.799129
ISSN=2297-055X
ABSTRACT=Background: Asian representation in sport is increasing, yet there remains a lack of reference values for the Asian athlete's heart. Consequently, current guidelines for cardiovascular screening recommend using Caucasian athletes' norms to evaluate Asian athletes. This study aims to outline electrocardiographic and echocardiographic characteristics of the Asian athlete's heart using a Singaporean prospective registry of Southeast (SE) Asian athletes.
Methods and Results: One hundred and fifty elite athletes, mean age of 26.1 ± 5.7 years (50% males, 88% Chinese), were evaluated using a questionnaire, 12-lead electrocardiogram (ECG) and transthoracic echocardiogram. All ECGs were analyzed using the 2017 International Recommendations. Echocardiographic data were presented by gender and sporting discipline. The prevalence of abnormal ECGs among SE Asian athletes was 6.7%—higher than reported figures for Caucasian athletes. The abnormal ECGs comprised mainly anterior T wave inversions (ATWI) beyond lead V2, predominantly in female athletes from mixed/endurance sport (9.3% prevalence amongst females). None had echocardiographic structural abnormalities. Male athletes had reduced global longitudinal strain compared to females (−18.7 ± 1.6 vs. −20.7 ± 2.1%, p < 0.001). Overall, SE Asian athletes had smaller left ventricular cavity sizes and wall thickness compared to non-Asian athletes.
Conclusion: SE Asian athletes have higher abnormal ECG rates compared to Caucasian athletes, and also demonstrate structural differences that should be accounted for when interpreting their echocardiograms compared to athletes of other ethnicities.