49 Ethnic variation in QT interval among highly trained athletes

Background Studies in Caucasian (white) athletes indicate that a significant proportion exhibit an isolated prolonged corrected QT interval (QTc), raising concerns for potentially false diagnoses and disqualification from competitive sport. The prevalence of prolonged QTc interval in athletes of African/Afro-Caribbean (black) descent is unknown. However, this ethnic group generally exhibits a high proportion of ECG repolarisation changes and increased left ventricular wall thickness, that may impact on QTc. Aim We aimed to assess the impact of ethnicity on QTc in young elite athletes. Methods We assessed 3035 elite athletes, aged 14–35 years, who were participating at national and international level in a variety of sporting disciplines. Athletes were evaluated with ECG and 2D echocardiography. Athletes diagnosed with structural heart disease or hypertension were excluded from analysis. Results Demographic and cardiological results are summarised in Abstract 49 table 1. Black male athletes exhibited shorter QTc than white male athletes, but QTc was similar among black and white female athletes. Bivariate analysis revealed that none of T wave inversions, ST segment elevation, or left ventricular wall thickness were associated with QTc. No ethnic difference was observed in prevalence of QT prolongation, as defined by ESC Sports Consensus criteria (male >440 ms; female >460 ms). Conclusion Despite demonstrating a higher prevalence of repolarisation changes and morphological left ventricular hypertrophy, black athletes do not exhibit a longer QTc than white counterparts. Based on ESC Sports Consensus criteria, prevalence of a long QTc in black and white athletes is similar, obviating the need for ethnicity specific criteria for defining a long QTc.