Evaluation of the Seattle and International Criteria in elite Nigerian athletes

Electrocardiographic findings in Nigerian athletes with the sickle cell trait

BACKGROUND

In spite of the high prevalence of the sickle cell trait (SCT) in Nigeria, the electrocardiographic characteristics of SCT athletes remain unknown.

OBJECTIVE

To compare the electrocardiographic findings in athletes of the University of Port Harcourt based on hemoglobin genotype.

METHODS

76 athletes (41 males, 35 females) were recruited. All had normal ECGs and echocardiograms. The prevalence of SCT was 31.6%.

RESULTS

Mean heart rate was lower among the SCT athletes (57.3 [8.6] vs 64.6 [10.4] beats/min; p = .002; Hedges' g = 0.74). Mean T-wave axis was also higher among SCT athletes (39.1 [12.8] vs 32.3 [12.9] degrees; p = .036 Hedges' g = 0.53).

CONCLUSION

SCT is associated with significant electrocardiographic changes in Nigerian athletes. The biological basis and clinical significance of these changes are presently uncertain.

The Impact of Ethnicity on Athlete ECG Interpretation: A Systematic Review

Athlete ECG interpretation criteria have been developed and refined from research in athlete populations; however, current guidelines are based on available data primarily from Caucasian and Black athletes. This study aimed to assess the impact of ethnicity on ECG interpretation in athletes. A systematic review was conducted of the MEDLINE, EMBASE, Scopus, SPORTDiscus, and Web of Science databases, for papers that assessed athlete screening ECGs and compared findings on the basis of ethnicity. Fifty-one papers which compared ECGs from various ethnicities were included. Most studies assessed Black athletes against Caucasian athletes and found a greater prevalence of T-wave inversion (TWI) (2.6–22.8% vs. 0–5.0%) and anterior TWI (3.7–14.3% vs. 0.6–2.0%). Black athlete subgroups in Africa had TWI (20–40%) and anterior TWI (4.3–18.7%) at a higher prevalence than other Black athletes. Athletes who were defined as mixed-race, Asian, and Pacific Islander are potentially more like Black athletes than Caucasian athletes. Black ethnicity is known to have an impact on the accurate interpretation of athlete ECGs; however, there is nuance related to origin of both parents. Asian and Pacific Islander origin also may impact athlete ECG interpretation. Further research is required to assist in distinguishing abnormal and normal athlete ECGs in different ethnic populations.