Cardiac adaptation to exercise in adolescent athletes of African ethnicity

An emergent elite athletic population

Nabeel Sheikh, Michael Papadakis, Francois Carre, Gaelle Kervio, Vasilis F. Panoulas, Saqib Ghani, Abbas Zaidi, Sabiha Gati, John Rawlins, Mathew G. Wilson, Sanjay Sharma

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Background/aims Adult black athletes (BA) exhibit left ventricular hypertrophy (LVH) on echocardiography and marked ECG repolarisation changes resembling those observed in hypertrophic cardiomyopathy (HCM). Limited data are available for adolescent BA, the group most vulnerable to exercise-related sudden cardiac death. Methods Between 1996 and 2011, 245 male and 84 female adolescent BA from a wide variety of sporting disciplines underwent cardiac evaluation including ECG and echocardiography. Athletes exhibiting T-wave inversions and/or echocardiographic LVH were investigated further for quiescent cardiomyopathies. Results were compared with 903 adolescent white athletes (WA) and 134 adolescent sedentary black controls (BC). Results LVH on echocardiography was present in 7% of BA compared to only 0.6% of WA and none of the BC. In the very young (<16 years), 5.5% of BA, but none of the WA, demonstrated LVH. Within the BA group, LVH was more prevalent in men compared to women (9% vs 1.2%, p=0.012). T-wave inversions were present in 22.8% BA, 4.5% WA and 13.4% BC. T-wave inversions in BA occurred with similar frequency in men and women and were predominantly confined to leads V1-V4. T-wave inversions in the lateral leads, commonly associated with cardiomyopathies, were present in 2.4% of BA. On a further evaluation and mean follow-up of 8.3 years, none of the athletes exhibited HCM. Conclusions Athletic training has a pronounced effect on adolescent BA. Black athletes as young as 14 years of age may exhibit left ventricular wall thicknesses of 15 mm and marked repolarisation changes resembling HCM. Male and female BA demonstrate a high prevalence of T-wave inversions.

Original languageEnglish
Pages (from-to)585-592
Number of pages8
JournalBritish Journal of Sports Medicine
Volume47
Issue number9
DOIs
Publication statusPublished - Jun 2013
Externally publishedYes

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Athletes
Sports
Exercise
Population
Left Ventricular Hypertrophy
Hypertrophic Cardiomyopathy
Echocardiography
Cardiomyopathies
Electrocardiography
Sudden Cardiac Death

Cite this

Sheikh, Nabeel ; Papadakis, Michael ; Carre, Francois ; Kervio, Gaelle ; Panoulas, Vasilis F. ; Ghani, Saqib ; Zaidi, Abbas ; Gati, Sabiha ; Rawlins, John ; Wilson, Mathew G. ; Sharma, Sanjay. / Cardiac adaptation to exercise in adolescent athletes of African ethnicity : An emergent elite athletic population. In: British Journal of Sports Medicine. 2013 ; Vol. 47, No. 9. pp. 585-592.
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title = "Cardiac adaptation to exercise in adolescent athletes of African ethnicity: An emergent elite athletic population",
abstract = "Background/aims Adult black athletes (BA) exhibit left ventricular hypertrophy (LVH) on echocardiography and marked ECG repolarisation changes resembling those observed in hypertrophic cardiomyopathy (HCM). Limited data are available for adolescent BA, the group most vulnerable to exercise-related sudden cardiac death. Methods Between 1996 and 2011, 245 male and 84 female adolescent BA from a wide variety of sporting disciplines underwent cardiac evaluation including ECG and echocardiography. Athletes exhibiting T-wave inversions and/or echocardiographic LVH were investigated further for quiescent cardiomyopathies. Results were compared with 903 adolescent white athletes (WA) and 134 adolescent sedentary black controls (BC). Results LVH on echocardiography was present in 7{\%} of BA compared to only 0.6{\%} of WA and none of the BC. In the very young (<16 years), 5.5{\%} of BA, but none of the WA, demonstrated LVH. Within the BA group, LVH was more prevalent in men compared to women (9{\%} vs 1.2{\%}, p=0.012). T-wave inversions were present in 22.8{\%} BA, 4.5{\%} WA and 13.4{\%} BC. T-wave inversions in BA occurred with similar frequency in men and women and were predominantly confined to leads V1-V4. T-wave inversions in the lateral leads, commonly associated with cardiomyopathies, were present in 2.4{\%} of BA. On a further evaluation and mean follow-up of 8.3 years, none of the athletes exhibited HCM. Conclusions Athletic training has a pronounced effect on adolescent BA. Black athletes as young as 14 years of age may exhibit left ventricular wall thicknesses of 15 mm and marked repolarisation changes resembling HCM. Male and female BA demonstrate a high prevalence of T-wave inversions.",
author = "Nabeel Sheikh and Michael Papadakis and Francois Carre and Gaelle Kervio and Panoulas, {Vasilis F.} and Saqib Ghani and Abbas Zaidi and Sabiha Gati and John Rawlins and Wilson, {Mathew G.} and Sanjay Sharma",
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Sheikh, N, Papadakis, M, Carre, F, Kervio, G, Panoulas, VF, Ghani, S, Zaidi, A, Gati, S, Rawlins, J, Wilson, MG & Sharma, S 2013, 'Cardiac adaptation to exercise in adolescent athletes of African ethnicity: An emergent elite athletic population', British Journal of Sports Medicine, vol. 47, no. 9, pp. 585-592. https://doi.org/10.1136/bjsports-2012-091874

Cardiac adaptation to exercise in adolescent athletes of African ethnicity : An emergent elite athletic population. / Sheikh, Nabeel; Papadakis, Michael; Carre, Francois; Kervio, Gaelle; Panoulas, Vasilis F.; Ghani, Saqib; Zaidi, Abbas; Gati, Sabiha; Rawlins, John; Wilson, Mathew G.; Sharma, Sanjay.

In: British Journal of Sports Medicine, Vol. 47, No. 9, 06.2013, p. 585-592.

Research output: Contribution to journalArticle

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T1 - Cardiac adaptation to exercise in adolescent athletes of African ethnicity

T2 - An emergent elite athletic population

AU - Sheikh, Nabeel

AU - Papadakis, Michael

AU - Carre, Francois

AU - Kervio, Gaelle

AU - Panoulas, Vasilis F.

AU - Ghani, Saqib

AU - Zaidi, Abbas

AU - Gati, Sabiha

AU - Rawlins, John

AU - Wilson, Mathew G.

AU - Sharma, Sanjay

PY - 2013/6

Y1 - 2013/6

N2 - Background/aims Adult black athletes (BA) exhibit left ventricular hypertrophy (LVH) on echocardiography and marked ECG repolarisation changes resembling those observed in hypertrophic cardiomyopathy (HCM). Limited data are available for adolescent BA, the group most vulnerable to exercise-related sudden cardiac death. Methods Between 1996 and 2011, 245 male and 84 female adolescent BA from a wide variety of sporting disciplines underwent cardiac evaluation including ECG and echocardiography. Athletes exhibiting T-wave inversions and/or echocardiographic LVH were investigated further for quiescent cardiomyopathies. Results were compared with 903 adolescent white athletes (WA) and 134 adolescent sedentary black controls (BC). Results LVH on echocardiography was present in 7% of BA compared to only 0.6% of WA and none of the BC. In the very young (<16 years), 5.5% of BA, but none of the WA, demonstrated LVH. Within the BA group, LVH was more prevalent in men compared to women (9% vs 1.2%, p=0.012). T-wave inversions were present in 22.8% BA, 4.5% WA and 13.4% BC. T-wave inversions in BA occurred with similar frequency in men and women and were predominantly confined to leads V1-V4. T-wave inversions in the lateral leads, commonly associated with cardiomyopathies, were present in 2.4% of BA. On a further evaluation and mean follow-up of 8.3 years, none of the athletes exhibited HCM. Conclusions Athletic training has a pronounced effect on adolescent BA. Black athletes as young as 14 years of age may exhibit left ventricular wall thicknesses of 15 mm and marked repolarisation changes resembling HCM. Male and female BA demonstrate a high prevalence of T-wave inversions.

AB - Background/aims Adult black athletes (BA) exhibit left ventricular hypertrophy (LVH) on echocardiography and marked ECG repolarisation changes resembling those observed in hypertrophic cardiomyopathy (HCM). Limited data are available for adolescent BA, the group most vulnerable to exercise-related sudden cardiac death. Methods Between 1996 and 2011, 245 male and 84 female adolescent BA from a wide variety of sporting disciplines underwent cardiac evaluation including ECG and echocardiography. Athletes exhibiting T-wave inversions and/or echocardiographic LVH were investigated further for quiescent cardiomyopathies. Results were compared with 903 adolescent white athletes (WA) and 134 adolescent sedentary black controls (BC). Results LVH on echocardiography was present in 7% of BA compared to only 0.6% of WA and none of the BC. In the very young (<16 years), 5.5% of BA, but none of the WA, demonstrated LVH. Within the BA group, LVH was more prevalent in men compared to women (9% vs 1.2%, p=0.012). T-wave inversions were present in 22.8% BA, 4.5% WA and 13.4% BC. T-wave inversions in BA occurred with similar frequency in men and women and were predominantly confined to leads V1-V4. T-wave inversions in the lateral leads, commonly associated with cardiomyopathies, were present in 2.4% of BA. On a further evaluation and mean follow-up of 8.3 years, none of the athletes exhibited HCM. Conclusions Athletic training has a pronounced effect on adolescent BA. Black athletes as young as 14 years of age may exhibit left ventricular wall thicknesses of 15 mm and marked repolarisation changes resembling HCM. Male and female BA demonstrate a high prevalence of T-wave inversions.

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U2 - 10.1136/bjsports-2012-091874

DO - 10.1136/bjsports-2012-091874

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JO - British Journal of Sports Medicine

JF - British Journal of Sports Medicine

SN - 0306-3674

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