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Int J Sports Med 2003; 24(4): 233-237
DOI: 10.1055/s-2003-39499
Physiology & Biochemistry
© Georg Thieme Verlag Stuttgart · New York

QT Dispersion in Elderly Athletes with Left Ventricular Hypertrophy

F.  Galetta1 , F.  Franzoni1 , G.  Santoro1 , F.  Prattichizzo2 , F.  R.  Femia1 , F.  Pastine1 , F.  Pentimone1
  • 1Department of Internal Medicine, University of Pisa, Pisa, Italy
  • 2Department of Internal Medicine, S. Miniato ASL, Empoli, Italy
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Publikationsverlauf

Accepted after revision: October 25, 2002

Publikationsdatum:
04. Juni 2003 (online)

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Abstract

The purpose of this study was to examine the QT dispersion in elderly endurance athletes with left ventricular (LV) hypertrophy. Sixteen athletes (males, mean age 67.6 ± 4.5 years) with mild to moderate LV hypertrophy, were compared with 16 age-matched hypertensive patients with similar degree of LV hypertrophy and 16 age-matched healthy sedentary controls. All the participants underwent echocardiogram and 12-lead electrocardiogram. QT dispersion was defined as the difference between maximum and minimum QT intervals in the different leads. QT dispersion was corrected (QTc) for heart rate according to Bazett's formula. The results showed in athletes and hypertensive patients comparable LV mass (258.2 ± 14.2 vs. 262.4 ± 16.8 g, ns), which was significantly higher than that of controls (p < 0.001). Trained subjects had QT dispersion (38.6 ± 10.2 ms) and QTc dispersion (39.4 ± 11.3 ms) significantly lower than hypertensive patients (QT dispersion: 68.4 ± 11.4 ms; QTc dispersion: 72.2 ± 8.4, p < 0.001) and comparable with controls (QT dispersion: 44.3 ± 8.4 ms; QTc dispersion: 46.2 ± 6.2 ms, ns). In conclusion, in elderly athletes training-induced myocardial hypertrophy was characterized by a QT dispersion significantly lower than hypertensive myocardial hypertrophy. This could provide a simple and inexpensive screening method for differentiating physiologic from pathologic myocardial hypertrophy in elderly subjects.

Key words

QT dispersion - left ventricular hypertrophy - elderly athletes

References

  • 1 Abildskov J A. Adrenergic effects of the QT interval on the electrocardiogram.  Am Heart J. 1976;  92 210-216
    PubMedSuche in Google Scholar
  • 2 Buchfuhrer M J, Hansen J E, Robinson T E, Sue D Y, Wasserman K, Whipp B J. Optimizing the exercise protocol for cardiopulmonary assessment.  J Appl Physiol. 1983;  55 1558-1564
    PubMedSuche in Google Scholar
  • 3 de Bruyne M C, Hoes A W, Kors J A, Hofman A, van Bemmel J H, Grobbee D E. QTc dispersion predicts cardiac mortality in the elderly. The Rotterdam study.  Circulation. 1998;  97 467-472
    CrossrefPubMedSuche in Google Scholar
  • 4 de Simone G, Daniels S R, Devereux R B, Meyer R A, Roman M J, de Divitiis O, Alderman M H. Left ventricular mass and body size in normotensive children and adults: assessment of allometric relations and of the impact of overweight.  J Am Coll Cardiol. 1992;  20 1251-1260
    CrossrefPubMedSuche in Google Scholar
  • 5 Devereux R B, Reichek N. Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method.  Circulation. 1977;  55 613-618
    PubMedSuche in Google Scholar
  • 6 Franz M R, Bargheer K, Costard-Jackle A, Miller D C, Lichtlen P R. Human ventricular repolarization and T wave genesis.  Prog Cardiovasc Dis. 1991;  33 369-384
    PubMedSuche in Google Scholar
  • 7 Gryglewska B, Grodzicki T, Czarnecka D, Kawecka-Jaszcz K, Kocemba J. QT dispersion and hypertensive heart disease in the elderly.  J Hypertens. 2000;  18 461-464
    CrossrefPubMedSuche in Google Scholar
  • 8 Halle M, Huonker M, Hohnloser S H, Alivertis M, Berg A, Keul J. QT dispersion in exercise-induced myocardial hypertrophy.  Am Heart J. 1999;  138 309-312
    PubMedSuche in Google Scholar
  • 9 Ichkhan K, Molnar J, Somberg J. Relation of left ventricular mass and QT dispersion in patients with systematic hypertension.  Am J Cardiol. 1997;  79 508-511
    CrossrefPubMedSuche in Google Scholar
  • 10 Kozakova M, Galetta F, Gregorini L, Bigalli G, Franzoni F, Giusti C, Palombo C. Coronary vasodilator capacity and epicardial vessel remodeling in physiological and hypertensive hypertrophy.  Hypertension. 2000;  36 343-349
    PubMedSuche in Google Scholar
  • 11 Kozakova M, Palombo C, Pratali L, Pittella G, Galetta F, L'Abbate A. Mechanism of coronary flow reserve impairment in human hypertension: an integrated approach by transthoracic and transesophageal echocardiography.  Hypertension. 1997;  29 551-559
    PubMedSuche in Google Scholar
  • 12 Lakatta E G. Cardiovascular regulatory mechanisms in advanced age.  Physiol Rev. 1993;  73 413-467
    PubMedSuche in Google Scholar
  • 13 Mall G, Zimmer G, Baden S, Mattfeldt T. Capillary neoformation in the rat heart-stereological studies on papilla muscles in hypertrophy and physiologic growth.  Basic Res Cardiol. 1990;  85 531-540
    PubMedSuche in Google Scholar
  • 14 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
    PubMedSuche in Google Scholar
  • 15 Mayet J, Shahi M, McGrath K, Poulter N R, Sever P S, Foale R A, Thom S A. Left ventricular hypertrophy and QT dispersion in hypertension.  Hypertension. 1996;  28 791-796
    PubMedSuche in Google Scholar
  • 16 Nordin C, Siri F, Aronson R S. Electrophysiologic characteristics of single myocytes isolated from hypertrophied guinea-pig hearts.  J Mol Cell Cardiol. 1989;  21 729-739
    CrossrefPubMedSuche in Google Scholar
  • 17 Pagani M, Lucini D. Autonomic dysregulation in essential hypertension: insight from heart rate and arterial pressure variability.  Auton Neurosci. 2001;  90 76-82
    PubMedSuche in Google Scholar
  • 18 Pluim B M, Beyerbacht H P, Chin J C, Zwinderman A, van der Laarse A, de Roos A, Vliegen H W, van der Wall E E. Comparison of echocardiography with magnetic resonance imaging in the assessment of the athlete's heart.  Eur Heart J. 1997;  18 1505-1513
    PubMedSuche in Google Scholar
  • 19 Pye M, Quinn A C, Cobbe S M. QT interval dispersion: a non-invasive marker of susceptibility to arrhythmia in patients with sustained ventricular arrhythmias?.  Br Heart J. 1994;  71 511-514
    PubMedSuche in Google Scholar
  • 20 Reardon M, Malik M. QT interval change with age in an overtly healthy older population.  Clin cardiol. 1996;  19 949-952
    PubMedSuche in Google Scholar
  • 21 Sahn D J, DeMaria A, Kisslo J, Weyman A. The committee on M-mode Standardization of the American Society of Echocardiography: recommendations regarding quantitation in M-mode echocardiography. Results of a survey of echocardiographic measurements.  Circulation. 1978;  58 1072-1083
    CrossrefPubMedSuche in Google Scholar
  • 22 Schuit A J, van Amelsvoort L G, Verheij T C, Rijneke R D, Maan A C, Swenne C A, Schouten E G. Exercise training and heart rate variability in older people.  Med Sci Sports Exerc. 1999;  31 816-821
    PubMedSuche in Google Scholar
  • 23 Yan G X, Rials S J, Wu Y, Liu T, Xu X, Marinchak R A, Kowey P R. Ventricular hypertrophy amplifies transmural repolarization dispersion and induces early afterdepolarization.  Am J Physiol. 2001;  281 H1968-H1975
    PubMedSuche in Google Scholar

Dr. F. Galetta

Department of Internal Medicine · University of Pisa School of Medicine

Via Roma 67 · 56126 Pisa · Italy ·

Telefon: +39-050-993373

Fax: +39-050-553414

eMail: fgaletta@med.unipi.it