Imaging associations enhance the understanding of ECG abnormalities in male Brazilian football players: findings from the B-Pro Foot ECG study
Imaging associations enhance the understanding of ECG abnormalities in male Brazilian football players: findings from the B-Pro Foot ECG study
Data
2024
Autores
Ferrari, Filipe
Silveira, Anderson D da
Ziegelmann, Patrícia K
Aleixo, Haroldo
Dilda, Guilherme D
Emed, Luiz G M
Magalhães, Flávia C O
Cardoso, Fernando B
Silva, Henrique C da
Guerra, Felipe E F
Journal Title
Journal ISSN
Volume Title
Publisher
British Journal of Sports Medicine
Resumo
Objectives To evaluate the prevalence of abnormal
ECG findings and their association with imaging results
in male Brazilian football players.
Methods The ’B-Pro Foot ECG’ is a multicentre
observational study conducted in 82 Brazilian
professional clubs. It analysed 6125 players aged 15–35
years (2496 white, 2004 mixed-race and 1625 black
individuals) who underwent cardiovascular screening
from 2002 to 2023. All ECGs were reviewed by two
experienced cardiologists in the athlete’s care. Those
with abnormal findings underwent further investigations,
including a transthoracic echocardiogram (TTE). Cardiac
magnetic resonance (CMR) was subsequently performed
based on TTE findings or clinical suspicion.
Results In total, 180 (3%) players had abnormal
ECGs and 176 (98%) showed normal TTE results.
Athletes aged 26–35 years had a higher prevalence
of abnormal ECGs than younger athletes (15–25
years). Black players had a higher prevalence of T-wave
inversion (TWI) in the inferior leads than white players
(2.6% vs 1.4%; p=0.005), as well as in V5 (2.9%) and
V6 (2.1%) compared with white (1.2% and 1.0%;
p<0.001) and mixed-race (1.5% and 1.2%; p<0.05)
players, respectively. TTE parameters were similar
across ethnicities. However, four out of 75 players with
inferolateral TWI showed abnormal TTEs and CMR
findings consistent with cardiomyopathies. CMR also
showed cardiomyopathies or myocarditis in four players
with inferolateral TWI and normal TTEs. In total, nine
(0.1%) athletes were diagnosed with cardiac diseases
and were followed for 40±30 months, with no cardiac
events documented.
Conclusion This study found a 3% prevalence of
abnormal ECGs in male Brazilian football players.
Inferolateral TWI was associated with cardiac pathologies
confirmed by CMR, even in athletes with a normal TTE.
Description
Palavras-chave
Athletes, Adolescent, Adult, Brazil / epidemiology, Echocardiography*, Electrocardiography*, Humans, Magnetic Resonance Imaging, Male, Prevalence, Soccer*, Young Adult.
Citação
Ferrari F, da Silveira AD, Ziegelmann PK, Aleixo H, Dilda GD, Emed LGM, Magalhães FCO, Cardoso FB, da Silva HC, Guerra FEF, Soares LG, Bassan F, Braga F, Herdy AH, Froelicher V, Stein R; B-Pro Foot ECG Collaborators. Imaging associations enhance the understanding of ECG abnormalities in male Brazilian football players: findings from the B-Pro Foot ECG study. Br J Sports Med. 2024 May 28;58(11):598-605. doi: 10.1136/bjsports-2023-108053.