Abstract
Screening for cardiac health should involve relevant parameters or indices that are
easy and inexpensive to obtain. Various cardiac adaptation mechanisms develop during
regular exercise that are affected by many factors, and these are reflected on a surface
electrocardiogram. QT dispersion has been considered a surrogate for heterogeneity
of repolarization, leading to ventricular arrhythmias. We compared QT parameters between
athletes and sedentary subjects. A total of 225 men were assessed, comprising a group
of professional soccer players and sedentaries. Each subject underwent supine 12-lead
electrocardiographic examinations and exercise testing by ergospirometry. QT parameters
were taken at rest and at peak exercise. Peak oxygen consumption was considerably
higher in the athletes than in the controls (59.3 ± 5.6 vs. 44.3 ± 2.4 ml/kg/min,
mean ± SD, p < 0.001). QT parameters at rest: There were significant differences in
heart-rate-corrected rest maximal QT duration (413.9 ± 50.5 vs. 445.3 ± 45.7 ms, p
< 0.001) and in heart-rate-corrected rest minimum QT duration (380.5 ± 51.2 vs. 409.5
± 46.7 ms, p < 0.001). QT parameters at peak exercise: maximal QT duration at peak
exercise (253.9 ± 20.8 vs. 261.7 ± 26.2, p = 0.02), QT dispersion at peak exercise
(25.2 ± 9.1 vs. 29.5 ± 15.8 ms, p = 0.04), heart-rate-corrected QT dispersion at peak
exercise (44.6 ± 16.4 vs. 52.6 ± 28.3 ms, p = 0.03) differed significantly between
professional soccer players and controls. QT dispersion and corrected QT dispersion
at peak exercise are lower in athletes than in controls. Athletes and other subjects
identified with a long QT interval should be examined at regular intervals.
Key words
QT dispersion - exercise testing - peak oxygen consumption - athlete’s heart - long-QT
syndrome
References
- 1
Arab D, Valeti V, Schünemann H J, Lopez-Candales A.
Usefulness of the QTc interval in predicting myocardial ischemia in patients undergoing
exercise stress testing.
Am J Cardiol.
2000;
85
764-766
- 2
Bazett HC.
An analysis of time relations of electrocardiograms.
Heart.
1920;
7
353-370
- 3
Bland JM, Altman D G.
Statical methods for assessing agreement between two methods of clinical measurement.
Lancet.
1986;
1
307-310
- 4
Day C P, McComb J M, Campbell R W.
QT dispersion in sinus beats and ventricular extrasystoles in normal hearts.
Br Heart J.
1992;
67
39-41
- 5
Dekker J M.
The value of the heart-rate corrected QT-interval for cardiovascular risk stratification.
Eur Heart J.
1999;
20
250-251
- 6
Dillenburg R F, Hamilton R M.
Is exercise testing useful in identifying congenital long QT syndrome?.
Am J Cardiol.
2002;
89
233-236
- 7
Halle M, Huonker M, Hohnloser S H.
QT dispersion in exercise-induced myocardial hypertrophy.
Am Heart J.
1999;
138
309-312
- 8
Jones N.
Evaluation of a microprocessor-controlled exercise testing system.
J Appl Physiol.
1984;
57
1312-1319
- 9
Kornitzer M.
Predictive value of electrocardiographic markers for autonomic nervous system dysfunction
in healthy populations: more studies needed.
Eur Heart J.
2001;
22
109-112
- 10
Krahn A D, Nguyen-Ho P, Klein G J, Yee R, Skanes A C, Suskin N.
QT dispersion: An electrocardiographic derivate of QT prolongation.
Am Heart J.
2001;
141
111-116
- 11
Malik M.
Measurement, interpretation and clinical potential of QT dispersion.
J Am Coll Cardiol.
2000;
36
1749-1766
- 12
Maron B J, Leyhe J M, Casey S A.
Assessment of QT dispersion as a prognostic marker for sudden death in a regional
nonreferred hypertrophic cardiomyopathy cohort.
Am J Cardiol.
2001;
87
114-115
- 13
Mayet J, Kanagaratnam P, Shahi M, Senior R, Doherty M, Poulter N R, Sever P S, Handler C E,
Thom S A, Foale R A.
QT dispersion in athletic left ventricular hypertrophy.
Am Heart J.
1999;
137
678-681
- 14
Okin M P, Devereux R B, Howard V B.
Assessment of QT interval and QT dispersion for QT dispersion for prediction of all-cause
and cardiovascular mortality in American indians. The strong heart study.
Circulation.
2000;
101
61-66
- 15
Schouten E G, Dekker J M, Meppelink P, Kok F J, Vandenbroucke J P, Pool J.
QT interval prolongation predicts cardiovascular mortality in an apparently healthy
population.
Circulation.
1991;
84
1516-1523
- 16
Siscovick D S, Weiss N S, Fletcher R H.
The incidence of primary cardiac arrest during vigorous exercise.
N Engl J Med.
1984;
311
874-877
- 17
Sokolow M, Lyon T P.
The ventricular complex in left ventricular hypertrophy obtained by unipolar precordial
and limb leads.
Am Heart J.
1949;
37
161-186
- 18
Soler-Soler J, Galve E.
QT dispersion after myocardial infarction with heart failure: additional prognostic
marker?.
Eur Heart J.
1999;
20
1146-1148
- 19
Toivonen L.
More light on QT interval measurement.
Heart.
2002;
87
193-194
- 20
Zabel M, Franz M R, Klingenheben T.
Rate-dependence of QT dispersion and the QT interval: Comparison of atrial pacing
and exercise testing.
J Am Coll Cardiol.
2000;
36
1654-1658
E. Kasikcioglu
Istanbul University · Istanbul Medical School · Department of Sports Medicine
Resitpasa c. Salkim s. No 2/5 · Avcilar · 34840 Istanbul · Turkey
Phone: +90 212 509 3540
Fax: +90 212 631 1317
Email: erhul@hotmail.com