Prevalence of electrocardiographic markers associated with myocardial fibrosis in masters athletes: a cohort study

• Published in: BMJ Open Sport & Exercise Medicine Vol. 10; no. 3; p. e001988
• Main Authors: Kramer, Tilmann, Ventovuori, Ville, Heinonen, Ari, Parkkari, Jari, Korhonen, Marko T, Rovio, Anja, Hoenemann, Jan-Niklas, Möstl, Stefan, Sies, Wolfram, Kaiser-Stolz, Claudia, Chilibeck, Philip, Tanaka, Hirofumi, Kramer, Mira, Rittweger, Joern, Hautala, Arto J
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 28.08.2024; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: Age; Aging; Athletes; Body mass index; Cardiology; Cardiology physiology; Cardiology prevention; Cardiovascular; Collagen; Cross country running; Data collection; Endurance; Ethics; Exercise; Females; Fitness training programs; Health care; Inclusion; Multiculturalism & pluralism; Original Research; Physical fitness; Sports; Tournaments & championships; Track & field; Germany; Endurance; Cardiology; Cardiology physiology; Cardiology prevention; Cardiovascular
• ISSN: 2055-7647; 2055-7647
• DOI: 10.1136/bmjsem-2024-001988

ObjectivesMyocardial fibrosis (MF) is associated with an increased predisposition to adverse cardiac events. The accumulation of high-volume and high-intensity exercise over an extended duration potentially increases the risk of MF. Specific electrocardiographic markers have been correlated with the presence of MF. This study assessed the prevalence of MF-related electrocardiographic markers in a Track and Field Master Athletics Cohort (TaFMAC).MethodsTwelve-lead resting electrocardiograms (ECGs) were conducted on 155 athletes (90 males and 65 females) participating in the World Masters Athletics 2022. The ECG markers associated with MF, including pathological Q waves, inverted T waves, fragmented QRS complex, and prolonged QRS complex, were compared among different athletic specialities (endurance athletes n=51, sprinters n=69 and strength and power n=35).ResultsOverall, 71 instances of MF-related markers were identified from 155 ECG recordings (46%). Fragmented QRS emerged as the most common marker, with a prevalence of 29% in endurance and strength and power athletes, and 35% in sprinters. No significant group differences were observed in the prevalence of MF markers, whether analysed collectively (p=0.467) or individually (pathological Q waves p=0.367, inverted T waves p=0.309, fragmented QRS complex p=0.747 and prolonged QRS complex p=0.132).ConclusionsThe prevalence of MF markers, as determined by resting ECG, was evident in nearly half of masters athletes, irrespective of sex and sporting specialisation. These findings suggest resting ECG as a promising non-invasive method for the early identification of MF in athlete’s hearts.