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Predictors of pathological ECG findings in military: relevance of demographic and exercise-related characteristics
Session:
Posters 2 - Écran 5 - Prevenção
Speaker:
Pedro M. Lopes
Congress:
CPC 2019
Topic:
J. Preventive Cardiology
Theme:
29. Rehabilitation and Sports Cardiology
Subtheme:
29.3 Sports Cardiology
Session Type:
Posters
FP Number:
---
Authors:
Pedro M. Lopes; Helder Dores; Rita Fernandes; Conceição Silveira; Sara Ferreira; José Monge
Abstract
<p><strong>Introduction:</strong> Screening individuals exposed to regular exercise training, as athletes and military, can lead to early identification of cardiac conditions associated with higher risk for sudden cardiac death. The methodology of this pre-participation evaluation has some limitations, namely due to the false positive cases of electrocardiogram (ECG), influenced by several factors.</p> <p><strong>Aim: </strong>To identify the independent predictors of pathological ECG findings in a population of male healthy military.</p> <p><strong>Methods and results:</strong> Prospective study of 1384 consecutive male healthy military (30±8 years-old, 95% Caucasian). The median hours of exercise training per week (h/w) was 5 [3; 7], 218 training (15.8%) ≥10h/w; 249 (18.0%) individuals were also involved in competitive sport. All the individuals performed a resting 12-lead ECG, interpreted according to the “International Recommendations for ECG Interpretation in Athletes”: normal traces - 431 (31.1%); physiological findings - 815 (58.9%); borderline findings - 75 (5.4%); pathological findings - 63 (4.6%). Individuals with pathological ECGs were younger (27.2±8.6 <em>vs.</em> 30.3±8.3 years-old; p=0.004), while black ethnicity (13.7% <em>vs.</em> 4.0%; p<0.001), concomitant competitive sport (8.4% <em>vs.</em> 3.7%; p=0.001) and training ≥10h/w (7.3% <em>vs.</em> 4.0%; p=0.031) were also associated with a higher rate of pathological ECGs. By multivariate analysis, age (OR 0,96; 95% CI 0.92-0.99; p=0.030); black ethnicity (OR 3.9; 95% CI 1.80-8.44; p=0.001) and competitive sport (OR 1.95; 95% CI 1.10-3.45; p=0.022) remained independent predictors. Only four military with pathological ECG were diagnosed with pathology.</p> <p><strong>Conclusions:</strong> In the military population studied, demographic (age, ethnicity) and exercise-related (level of competition) characteristics were associated with higher rate of pathological ECGs. Although these cases mostly correspond to false positive results, knowledge of these characteristics can improve the accuracy of pre-participation evaluation.</p>
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