One year cardiac follow up of young world cup football team compared to nonathletes

Abstract

Introduction: Sudden cardiac death among professional young athletes has become a significant concern mainly attributed to structural heart changes and ECG abnormalities. Objectives: We aimed primarily to compare echocardiographic and electrocardiographic changes in young professional athletes versus a control group of sedentary lifestyled nonathletic individuals of the same age group. Secondly, we aimed to follow up echocardiographic and electrocardiographic changes in young professional athletes after one year. Methods: We conducted the study from May 2008 to May 2009 by clinical examination, transthoraxic echocardiography and 12 lead ECG. Our study group was the national football team candidates for the youth world cup occurring in Cairo 2009. This study group was compared to a control group of randomly picked nonathletic third year medical students after exclusion of anyone with a known medical illness. The study group was classified into Athletes I representing athletes at the beginning of the study and Athletes II representing athletes after one year follow up. Results: The Study group comprised 34 males, mean age 18.82 ± 1.56 years while the Control group comprised 28 males, age mean 19.64 ± 2.31 years. There was not a significant difference between the two groups regarding number, age, height or weight (P > 0.05). Athletes I vs control: Clinical parameters showed significantly lower Systolic Blood Pressure SBP (athletes 117.79 ± 6.536, control 126.43 ± 17.043, P = 0.008) and Heart Rate HR (athletes 68.88 ± 5.044, control 77.43 ± 6.033, P = 0.001). ECG parameters showed a significantly longer RR interval (athletes 0.88 ± 0.065, control 0.76 ± 0.078, P = 0.001), while Corrected QTc interval was not significantly different (athletes 0.41 ± 0.029, control 0.42 ± 0.022, P > 0.05). Echo parameters showed a significant increase in Ejection fraction EF (athletes 60.94 ± 3.084 vs control 54.14 ± 13.063, P = 0.005) and Left atrial dimension LA (athletes 3.28 ± 0.392 vs control 2.58 ± 1.321, P = 0.005). On the other hand Septal wall in diastole SWD, Right ventricle dimension RV, Left ventricular end systolic dimension LVESD, Left Ventricular End Diastolic Dimension LVEDD, Aortic Root AO, and Posterior wall in diastole PWD were not significantly different (P > 0.05). Athletes II vs control: QTc became significantly longer (athletes 0.43 ± 0.028 vs control 0.42 ± 0.022, P = 0.05). SWD was significantly thicker (athletes 1.21 ± 0.23 vs control 1.07 ± 0.17, P = 0.04). SBP, HR remained significantly lower and RR, EF, LA remained significantly greater (P 0.05). Athletes I vs athletes II: ECG parameters showed a significant increase in QTc (0.41 ± 0.029 vs 0.43 ± 0.028, P = 0.005) and RR interval (0.81 ± 0.167 vs 0.88 ± 0.065, P = 0.046). Echo parameters showed a significant increase in SWD (1.21 ± 0.232 vs 0.93 ± 0.124, P 0.05). Conclusions: Professional football playing in young males results in significant changes compared to their control of sedentary nonathletic medical students of similar age. Clinical parameters showed a significant decrease in systolic blood pressure SBP and heart rate HR, ECG parameters showed significant increase in RR interval and QTc interval, and Echocardiographic parameters showed a significant increase in Left atrium diameter LA, Septal wall in diastole SWD, and ejection fraction EF. One year of professional football playing in young males causes a continuing significant increase in ECG parameters QTc, RR interval, and echocardiographic parameters SWD, LA, Right ventricle dimension RV, Posterior wall in diastole PWD and decrease in Left ventricular end systolic diameter LVESD compared to themselves one year earlier. The international concern of Sudden cardiac death among professional young athletes may be attributed to Structural heart changes and ECG abnormalities acquired with professional training.

Keywords

• Athletes
• Cardiac
• Clinical
• ECG
• ECHO
• Football
• Training
• Sudden death