Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Oct 26, 2016; 8(10): 590-595
Published online Oct 26, 2016. doi: 10.4330/wjc.v8.i10.590
Left ventricular false tendons and electrocardiogram repolarization abnormalities in healthy young subjects
Zlatan Lazarevic, Emanuela Ciminelli, Federico Quaranta, Fabio Sperandii, Emanuele Guerra, Fabio Pigozzi, Paolo Borrione
Zlatan Lazarevic, Federico Quaranta, Fabio Sperandii, Emanuele Guerra, Fabio Pigozzi, Paolo Borrione, University Foundation Foro Italico, 00135 Rome, Italy
Emanuela Ciminelli, Federico Quaranta, Fabio Sperandii, Fabio Pigozzi, Paolo Borrione, Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy
Author contributions: All authors contributed equally to this work; Lazarevic Z collected and analyzed the data and drafted the manuscript; Lazarevic Z and Borrione P designed and supervised the study; Ciminelli E, Quaranta F, Sperandii F, Guerra E, Pigozzi F and Borrione P revised the manuscript for important intellectual content; all the authors have read and approved the final version to be published.
Institutional review board statement: This study retrospectively and anonymously analyzed clinical data routinely collected during the pre-participation screening of competitive athletes. For this reason, ethics committee approval was not required.
Informed consent statement: Subjects were not required to give informed consent for the study since the analysis used anonymous clinical data.
Conflict-of-interest statement: There are no financial or other relationships that might lead to a conflict of interest in this study.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Paolo Borrione, MD, Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro de Bosis n. 6, 00135 Rome, Italy. paolo.borrione@uniroma4.it
Telephone: +39-063-6733253 Fax: +39-063-673344
Received: March 8, 2016
Peer-review started: March 9, 2016
First decision: May 17, 2016
Revised: July 15, 2016
Accepted: August 6, 2016
Article in press: August 8, 2016
Published online: October 26, 2016
Processing time: 231 Days and 20.4 Hours
Abstract
AIM

To describe echocardiographically left ventricular false tendon characteristics and the correlation with ventricular repolarization abnormalities in young athletes.

METHODS

Three hundred and sixteen healthy young athletes from different sport disciplines were evaluated from 2009 to 2011 during routine screening for agonistic sports eligibility. All subjects, as part of standard pre-participation screening medical evaluation, underwent a basal and post step test 12-lead electrocardiogram (ECG). The athletes with abnormal T-wave flattening and/or inversion were considered for an echocardiogram evaluation and an incremental maximal exercise test on a cycle ergometer. Arterial blood pressure and heart rate, during and after exercise, were also measured.

RESULTS

Twenty-one of the 316 subjects (6.9%) showed false tendons in the left ventricle. The majority of false tendons (52.38%) were localized between the middle segments of the inferior septum and the lateral wall, 19.06% between the distal segments of the septum and the lateral wall, in 5 subjects between the middle segments of the anterior and inferior walls, and in one subject between the middle segments of the anterior septum and the posterior wall. ECG abnormalities, represented by alterations of ventricular repolarization, were found in 11 subjects (52.38%), 90% of these anomalies were T wave abnormalities from V1 to V3. These anomalies disappeared with an increasing heart rate following the three minute step test as well as during the execution of the maximal exercise.

CONCLUSION

Left ventricular false tendons are frequently localized between the middle segments of the inferior septum and the lateral wall and are statistically associated with ventricular repolarization abnormalities.

Keywords: Repolarization anomalies, T wave inversion, Young athletes, False chordae tendineae, Echocardiography

Core tip: Ventricular repolarization abnormalities of subjects with false tendons were most frequently inverted T waves from V1 to V3. In this study, statistically significant associations between the presence of false tendons in the left ventricle and ventricular repolarization abnormalities in young healthy athletes were found. Furthermore, this study provides useful information for sports physicians when basic electrocardiogram abnormalities of ventricular repolarization are considered.