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"Medicina Sportiva" No.14 - 2008 The 15-th Sports Medicine Balkan Congress
SPORTS CARDIOLOGY


CAN THE RIGHT VENTRICULAR OUTFLOW FUNCTION BE CORRELATED WITH QRS ABNORMALITIES IN THE RIGHT PRECORDIAL AND UPPER RIGHT PRECORDIAL LEADS (BRUGADA LEADS)? - AN ECG-ECHOCARDIOGRAPHIC STUDY

Ioana Stoian, O. Chioncel, Ileana tepes Piser, A. Carp, I. Stoian, C. Macarie
Romania


Purpose – to analyze the correlation between the RSR’ patern in right precordial leads (V1-V3) and upper precordial leads (V1-V3 Brugada leads ) on standard ECG and the right ventricular outflow function ( evaluated by standard echocardiography ) in highly trained athletes. Material. Gr.I ( control normal ) – 610 c. (280 males; 31±12 years); Gr.II (highly trained athletes: kayak, canoe, rowing)-110 c.(82 males;23±7 years). Methods 1) standard 12 leads ECG – one/two upper space right precordial leads (V1-V3, Brugada ledas). 2) echocardiography – right ventricular outflow tract (RVOT) – short axis parasetrnal ( diameters; ejection fraction; wall thickness); right ventricular inflow tract (RVIT) – apical 4 chamber (diameters; TAPSE;dP/dt)

Results.
  Gr. I Gr. II
Nr. 610 110
RSR’ V1-V3 6%42%
RSR’ V1-V3 upper leads 16% 68%
QRS (ms)80±10 100±20
RVOT diameter 21±3 27±8,p<0,05
Wall tichkness RVOT (mm) 2±0,5 3,5±0,5,p<0,01
RV EF (%)41±15 48±18
RVIT diameter (mm) 24±3 26±4
TAPSE (mm)17±8 21±8
RV dP/dt 427±18 441±25
  RV – right ventricle; RVOT – right ventricular outflow tract; RVIT – right ventricular inflow tract;
                  TAPSE – tricuspid annular plane systolic excursion; EF – ejection fraction.

Conclusions. 1) The RSR’ pattern was associated with larger RVOT diameter (27±8, p<0,05) and thicken RVOT free wall (3,5±0,5, p<0,01) in highly trained athletes. 2) The RSR’ pattern in right precordial leads (V1-V3) and upper right precordial leads ( V1-V3 Brugada leads ) on standard ECG was observed in the majority of highly trained athletes ( Gr. II: 42%/68% ) comparing with normal subjects (Gr. I: 6%/16% ).





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