Association of ECG early repolarization phenomena and “T-infantile” with autonomic regulation of the heart rhythm in young athletes
DOI:
https://doi.org/10.14739/2310-1210.2020.3.204943Keywords:
“Т-infantile”, young athletes, autonomic balanceAbstract
The incidence of autonomic disorders in athletes varies widely from 6.2 % to 36.5 %. With the improving sport qualification, the frequency and severity of autonomic dysfunction increase. Various ECG phenomena, including SEVR and “T-infantile” are associated with a type of autonomic tone. Moreover, ANS dysfunction does not determine the genesis, but only contributes to the manifestation of these syndromes signs. The association between the ECG phenomena and autonomic dysfunction nature, age and gender of athletes remains an open question.
The purpose of this work was to study the incidence of juvenile T-wave and SEVR, their association with the autonomic regulation of heart rate in young athletes in the age range between 6 and 17 years.
Materials and methods. An electrocardiographic study and 5-minute recordings of the heart rate variability were carried out in 3720 children and adolescents aged between 6 and 17 years, of them 74.6 % were boys (n = 2774) and 25.4 % were girls (n = 946), engaged in various sports.
The study results. The “T-infantile” phenomenon was detected in 1.5 % (56/3720) of athletes, among them 1.07 % (40) were boys and 0.43 % (16) were girls. In five (12.5 %) athletes, “T-infantile” was combined with incomplete right bundle branch block, in 3 (7.5 %) – with short PQ syndrome, and in one (2.5 %) – with SEVR. In addition to the ECG signs of “T-infantile”, three (18.75 %) athletes additionally had incomplete RBBB, and also short PQ syndrome was detected in one athlete (6.25 %).
A comparative analysis of HRV indices in boys and girls with the “T-infantile” phenomenon showed that in boys, the D value was significantly higher, reflecting the vagal regulation activity of the heart rhythm (0.403 ± 0.028 s versus 0.311 ± 0.025 s, P = 0.019). When assessing the autonomic state according to R. M. Baevsky, it was found that 40 % (n = 16) of male athletes with T-infantile ECG phenomenon had an increased parasympathetic nervous system tone, 50 % (n = 20) had normal ANS tone, and 10 % (n = 4) had an increased sympathetic nervous system tone. In girls, there were 31.25 % (n = 5) with increased PNS tone, 50 % (n = 8) with normal ANS tone and 18.75 % (n = 3) with increased SNS tone, respectively.
Conclusions. Early repolarization syndrome and “T-infantile” are more common in case of increased parasympathetic nervous system tone rather than in other variants of autonomic tone. A combination of parasympathetic overactivity with these ECG phenomena is observed mainly in males. The phenomenon of “T-infantile” can be combined with incomplete right bundle branch block in young athletes of both sexes.
References
Abramova, V. R. (2006). Morfofunktsional'nyye osobennosti adaptatsii i uroven' fizicheskoy podgotovlennosti organizma yunykh sportsmenov 11-16 let korennogo naseleniya Respubliki Sakha (Yakutiya) : avtoref. dis. … kand. biol. nauk : spets. 03.00.13 [Morphological and functional features of adaptation and the level of physical fitness of the body of young athletes 11-16 years old of the indigenous population of the Republic of Sakha (Yakutia)]. Extended abstract of candidate`s thesis. Tyumen State University. [in Russian].
Baevskii, R. M., & Berseneva, A. P. (1997). Otsenka adaptatsionnykh vozmozhnostei organizma i risk razvitiya zabolevanii [Assessment of the adaptive capabilities of the body and the risk of developing diseases]. Moscow: Meditsina. [in Russian].
Venevtseva, Yu. L., Balko, A. S., & Mel'nikov, A. Kh. (2019). Osobennosti vegetativnogo statusa molodykh lyudey s EKG-fenomenom ranney repolyarizatsii zheludochkov serdtsa [Features of the vegetative status of young people with an ECG phenomenon of early repolarization of the ventricles of the heart]. Rossiiskii kardiologicheskii zhurnal, (4s2). 13. [in Russian].
Gorokhov, S. S. (2013). Sindrom ranney repolyarizatsii zheludochkov na EKG – sovremennoye sostoyaniye voprosa: Soobshcheniye 1. [The syndrome of early ventricular repolarization on the ECG - the current state of the issue: Message 1]. Voyennaya meditsina, (4), 117-124. [in Russian].
Tikhvinskii, S. B., & Khrushchev, S. V. (Eds). (1991). Detskaya sportivnaya meditsina [Children's sports medicine] (2nd ed.). Moscow: Meditsina. [in Russian].
Butchenko, L. A., Kushakovskii, M. S., & Zhuravleva, N. B. (1980). Distrofiya miokarda u sportsmenov [Myocardial dystrophy in athletes]. Moscow: Meditsina. [in Russian].
Iordanskaya, F. A., Buchina, Ye. V., & Tsepkova, N. K. (2016). Vozrastnye polovye osobennosti adaptatsii serdechno-sosudistoi i vegetativno-nervnoi sistem v obespechenii rabotosposobnosti grebtsov akademistov [Age and sex characteristics of adaptation of the cardiovascular and autonomic nervous system in ensuring the health of rowers rowing]. Vestnik sportivnoi nauki, (3), 23-29. [in Russian].
Kurbanova, I. M. (2002). Funktsional'noe sostoyanie vegetativnoi nervnoi i serdechno-sosudistoi sistem u yunykh sportsmenov : dis. kand. med. nauk: 14.00.09 Pediatriya [The functional state of the autonomic nervous and cardiovascular systems in young athletes]. Extended abstract of candidate`s thesis. Ivanovo State Medical Academy. [in Russian].
Mitin, M. S. (2015). Rasprostranennost' i vyrazhennost' vegetativnoi disfunktsii sredi molodykh sportsmenov [The prevalence and severity of autonomic dysfunction among young athletes]. Nauchnyi rezul'tat. Seriya Meditsina i farmatsiya,1(2), 30-38. [in Russian].
Mikhaylov, V. M. (2002). Variabel'nost' ritma serdtsa: opyt prakticheskogo primeneniya metoda [Heart rate variability: experience of the practical application of the method]. (2nd ed.). Ivanovo: Ivanovo State Medical Academy. [in Russian].
Pavlov, V. I., Pachina, A. B., Ivanova, Yu. M., & Sharoiko, M. V. (2009). Otsenka elektrokardiograficheskikh izmenenii pri dispanserizatsii sportsmenov [Assessment of electrocardiographic changes during medical examination of athletes]. Vestnik aritmologii, (Suppl. A), 163-164. [in Russian].
Pshenichnaya, Ye. V., & Prokhorov, Ye. V. (2019). Narusheniya ritma serdtsa u uslovno-zdorovykh mal'chikov-podrostkov predprizyvnogo vozrasta [Heart rhythm disturbances in conditionally healthy teenage boys of business age]. Rossiiskii kardiologicheskii zhurnal, 24(Suppl.), 18. [in Russian].
Skuratova, N. A. (2010). Sportivnoye serdtse [Athletic heart]. Problemy zdorov'ya i ekologii, (2), 71-77. [in Russian].
Skuratova, N. A. (2016). Sindrom rannei repolyarizatsii zheludochkov u detei i podrostkov: diagnosticheskii algoritm pri dopuske k fizicheskim nagruzkam [Early repolarization syndrome in children and adolescents: diagnostic algorithm to allow children to do physical exercise]. Problemy zdorov'ya i ekologii, (4), 96-100. [in Russian].
Telesheva, I. A., Makarov, L. M., & Komolyatova, V. N. (2019). Klinicheskoe znachenie nekotorykh EKG-fenomenov u detei s somaticheskoi patologiei [Clinical significance of some ECG phenomena in children with somatic pathology]. Rossiiskii kardiologicheskii zhurnal, 24(Suppl.), 15. [in Russian].
Shiyan, A. V. (2005). Osobennosti funktsional'nogo sostoyaniya serdechno-sosudistoi sistemy i vegetativnogo statusa u detei i podrostkov : avtoref. dis. … kand. biol. nauk: spets. 03.00.13 [Features of the functional state of the cardiovascular system and autonomic status in children and adolescents]. Extended abstract of candidate`s thesis. Kuban State University of Physical Education, Sport and Tourism. [in Russian].
Sandruchchi, M. G., & Bono, G. (1966). Elektrokardiografiya v detskom vozraste s elementami fonokardiografii i ballistokardiografii [Electrocardiography in childhood with elements of phonocardiography and ballistic cardiography]. Moscow: Meditsina. [in Russian].
Corrado, D., Pelliccia, A., Bjornstad, H. H., Vanhees, L., Biffi, A., Borjesson, M., … Thiene, G. (2005). Cardiovascular pre-participation screening of young competitive athletes for prevention of sudden death: proposal for a common European protocol - Consensus statement of the Study Group of Sport Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology. European Heart Journal, 26(5), 516-524. https://doi.org/10.1093/eurheartj/ehi108
Migliore, F., Zorzi, A., Michieli, P., Marra, M. P., Siciliano, M., Rigato, I., Bauce, B., Basso, C., Toazza, D., Schiavon, M., Iliceto, S., Thiene, G., & Corrado, D. (2012). Prevalence of Cardiomyopathy in Italian Asymptomatic Children With Electrocardiographic T-Wave Inversion at Preparticipation Screening. Circulation, 125(3), 529-538. https://doi.org/10.1161/circulationaha.111.055673
Papadakis, M., Basavarajaiah, S., Rawlins, J., Edwards, C., Makan, J., Firoozi, S., Carby, L., & Sharma, S. (2009). Prevalence and significance of T-wave inversions in predominantly Caucasian adolescent athletes. European Heart Journal, 30(14), 1728-1735. https://doi.org/10.1093/eurheartj/ehp164
Pelliccia, A., Culasso, F., Di Paolo, F. M., Accettura, D., Cantore, R., Castagna, W., … Di Luigi, L. (2007). Prevalence of abnormal electrocardiograms in a large, unselected population undergoing pre-participation cardiovascular screening. European Heart Journal, 28(16), 2006-2010. https://doi.org/10.1093/eurheartj/ehm219
Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. (1996). Circulation, 93(5), 1043-1065.
Ziegler, R. F. (1951). Electrocardiographic Studies in Normal Infants and Children. Springfield, Illinois, Charles C Thomas Publisher.
Zuckermann, R. (1959). Grundri und Atlas der Electrocardiographie. Leipzig: Verlag Georg Thieme
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