Research Article
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Year 2017, Volume: 19 Issue: 3, 313 - 321, 30.12.2017
https://doi.org/10.15314/tsed.369620

Abstract

References

  • Akıllı NB, Akıncı E, Akıllı H, Dündar ZD, Köylü R, Polat M, Cander B. A new marker for myocardial injury in carbonmonoxide poisoning: T peak–T end. American Journal of Emergency Medicine, 2013; 31: 1651–1655.
  • Alizade E, Avcı, A, Fidan S, Tabakçı M, Bulut M, Zehir R, Akçakoyun M. The effect of chronic anabolic–androgenic steroid use on Tp‐E interval, Tp‐E/Qt ratio, and Tp‐E/Qtc ratio in male bodybuilders. Annals of Noninvasive Electrocardiology, 2015; 20(6): 592-600.
  • Antzelevitch C. Tpeak–Tend interval as an index of transmural dispersion of repolarization. European journal of clinical investigation, 2001; 31(7): 555-557.
  • Baldesberger S, Bauersfeld U, Candinas R Seifert B, Zuber M, Ritter M, Jenni R, Oechslin E, Luthi P, Scharf C, Marti B, Attenhofer Jost CH. Sinus node disease and arrhythmias in the long-term follow-up of former professional cyclists. Eur Heart J, 2008; 29 (1): 71–78.
  • Braschi A, Francavilla VC, Abrignani MG, Todaro L, Francavilla G. Behavior of repolarization variables during exercise test in the athlete's heart. Annals of Noninvasive Electrocardiology, 2012; 17(2): 95-100.
  • Buchheıt M, Gındre C. Cardiac parasympathetic regulation: Respective associations with cardiorespiratory fitness and training load. Am J Physiol Heart Circ Physiol, 2006; 291(1): 451-458.
  • Devereux RB, Reichek N. Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method. Circulation, 1977; 55: 613–618.
  • Fagard R. Athlete’s heart. Heart, 2003; 89(12): 1455-1461.
  • Florescu M, Vınereanu D. How to differentiate athletes heart from pathological cardiac hypertrophy? Mædica A Journal of Clinical Medicine, 2006; 1: 19-26.
  • Gupta P, Patel C, Patel H, Narayanaswamy S, Malhotra B, Green JT, Yan GX. Tp-e/QT ratio as an index of arrhythmogenesis. Journal of Electrocardiology, 2008; (41): 567–574.
  • Hart G. Exercise induced hypertrophy: a substrate for sudden death in athletes? Experimental Physiology, 2003; 88(05): 639-644.
  • Heineke J, Molkentin JD. Regulation of cardiac hypertrophy by intracellular signalling pathways. Nature reviews Molecular cell biology, 2006; 7(8): 589-600.
  • Hevia JC, Antzelevitch C, Bárzaga FT, Sánchez MD, Balea FD, Molina RZ, Rodríguez, YF. T peak-T end and T peak-T end dispersion as risk factors for ventricular tachycardia/ventricular fibrillation in patients with the Brugada syndrome. Journal of the American College of Cardiology, 2006; 47(9): 1828-1834.
  • Hlaing T, Guo D, Zhao X, Di Mino T, Greenspon L, Kowey PR, Yan GX. The QT and Tpe intervals in left and right chest leads: comparison between patients with systemic and pulmonary hypertension. Journal of electrocardiology, 2005; 38(4): 154-158.
  • Hong L, Andersen LJ, Graff C, Vedel-Larsen E, Wang F, Struijk JJ, Kanters JK. T-wave morphology analysis of competitive athletes. Journal of electrocardiology, 2015; 48(1): 35-42.
  • Huston TP, Puffer JG, Mac Millan Rodney WM. The athletic heart syndrome. N Engl J Med, 1985; 313: 24–32.
  • Icli A, Kayrak M, Akilli H, Aribas A, Coskun M, Ozer SF, Ozdemir K. Prognostic value of Tpeak-Tend interval in patients with acute pulmonary embolism. BMC cardiovascular disorders, 2015; 15(1): 99.
  • Kayrak M, Acar K, Gul EE, Ozbek O, Abdulhalikov T, Sonmez O, Alibaşiç H. The association between myocardial iron load and ventricular repolarization parameters in asymptomatic beta-thalassemia patients. Adv Hematol, 2012; (2012): 170510.
  • Kiss O, Sydó N, Vargha P, Édes E, Merkely G, Sydó T, Merkely B. Prevalence of physiological and pathological electrocardiographic findings in Hungarian athletes. Acta Physiologica Hungarica, 2015; 102(2): 228-237.
  • Kreger BE, Cupples LA, Kannel WB. The electrocardiogram in prediction of sudden death: Framingham Study experience. American Heart Journal, 1987; 113(2): 377-382.
  • Lattanzi F, Di Bello V, Picano E, Caputo MT, Talarico L, Di Muro C, Distante A. Normal ultrasonic myocardial reflectivity in athletes with increased left ventricular mass. A tissue characterization study. Circulation, 1992; 85(5): 1828-1834.
  • Marcus R, Krause L, Weder AB, Dominguez-Meja A, Schork NJ, Julius S. Sex-specific determinants of increased left ventricular mass in the Tecumseh Blood Pressure Study. Circulation, 1994; 90: 928–936.
  • Maron BJ. Sudden death in young athletes. New England Journal of Medicine, 2003; 349(11): 1064-1075.
  • McCann GP, Muir DF, Hillis WS. Athletic left ventricular hypertrophy: Long-term studies are required. Eur Heart J, 2000; 21: 351–353.
  • McIntyre H, Fry CH. Abnormal action potential conduction in isolated human hypertrophied left ventricular myocardium. Journal of cardiovascular electrophysiology, 1997; 8(8): 887-894.
  • Mont L, Elosua R, Brugada J. Endurance sport practice as a risk factor for atrial fibrillation and atrial flutter. Europace, 2009; 11 (1): 11–17.
  • Morin DP, Saad MN, Shams OF, Owen JS, Xue JQ, Abi-Samra FM, Milani RV. Relationships between the T-peak to T-end interval, ventricular tachyarrhythmia, and death in left ventricular systolic dysfunction. Europace, 2012; 14: 1172-1179.
  • Omiya K, Sekizuka H, Kida K, Suzuki K, Akashi YJ, Ohba H, Musha H. Influence of gender and types of sports training on QT variables in young elite athletes. European Journal of Sport Science, 2014; 14(S1): 32-38.
  • Pavlik G, Major Z, Varga-Pinter B, Jeserich M, Kneffel Z: The athlete’s heart Part I (Review). Acta Physiol. Hung, 2010; 97: 337–353.
  • Pelliccia A, Di Paolo FM, Quattrini FM, Basso C, Culasso F, Popoli G, De Luca R, Spataro A, Biffi A, Thiene G, Maron BJ. Outcomes in athletes with marked ECG repolarization abnormalities. N Engl J Med, 2008; 358(2): 152–161.
  • Russo V, Ammendola E, De Crescenzo I, Ricciardi D, Capuano P, Topatino A, Docimo L, Santangelo L, Calabrò R. Effect of weight loss following bariatric surgery on myocardial dispersion of repolarization in morbidly obese patients. Obes Surg, 2007; 17(7): 857-86.
  • Sharashidze N, Pagava Z, Saatashvili G, Kishmarcia T, Agladze R. Exercise induced QT Dispersion changes in middle-aged veteran elite athletes. Georgian Med News, 2008; (157): 53-55.
  • Shimizu M, Ino H, Okeie K, Yamaguchi M, Nagata M, Hayashi K, Mabuchi H. T‐peak to T‐end interval may be a better predictor of high‐risk patients with hypertrophic cardiomyopathy associated with a cardiac troponin I mutation than QT dispersion. Clinical Cardiology, 2002; 25(7): 335-339.
  • Sorokin AV, Araujo CGS, Zweibel A, Thompson PD. Atrial fibrillation in endurance-trained athletes. Br J Sports Med, 2011; 45(3):185-188.
  • Tatlisu MA, Özcan KS, Güngör B, Ekmekçi A, Çekirdekçi EI, Arugarslan E, Erdinler I. Can the T-peak to T-end interval be a predictor of mortality in patients with ST-elevation myocardial infarction? Coronary Artery Disease, 2014; 25(5): 399-404.
  • Thompson PD. D. Bruce Dill. Historical lecture. Historical concepts of the athlete's heart. Medicine and Science in Sports and Exercise, 2004; 36(3): 363-370.
  • Whyte GP, Sheppard M, George KP, Shave RE, Wilson M, Stephens N, Senior R, Sharma S. Arrhythmias and the athlete: mechanisms and clinical significance. Eur Heart J, 2007; 28(11): 1399–1401 author reply 1401.
  • Yan GX, Rials SJ, Wu Y, Liu T, Xu X, Marinchak RA, Kowey PR. Ventricular hypertrophy amplifies transmural repolarization dispersion and induces early after depolarization. Am J Physiol Heart Circ Physiol, 2001; 281(5): 1968- 1975.

A novel marker to determine arrhytmia risk in elite cyclists: T peak T end

Year 2017, Volume: 19 Issue: 3, 313 - 321, 30.12.2017
https://doi.org/10.15314/tsed.369620

Abstract

In athletes, left ventricular hypertrophy is a physiological response upon routine active sports. If the hypertrophic cardiomyopathy is not diagnosed and treated, it can lead to sudden deaths in athletes. Not so much data is known whether or not it is favorable to use of Tp-e values in order to reflect the arrhythmia risks in asymptomatic elite cyclists. The aim of this study is to examine the risks of regular bike sport on potential arrhythmia in healthy active elite cyclists and veterans by using non-invasive cardiac tests. Study groups were: healthy volunteers (group 1, n=28, mean age 35.8±4.6), active cyclists (group 2, n=27, mean age 21±3.0), veteran cyclists (group 3, n=27, mean age 29.5±7.1 yr). All groups were underwent cardiological examinations, 12 derivation ECG records, transthoracic echocardiography investigations. Tp-e interval, Tp-e dispersion, corrected Tp-e interval, QT interval and Tp-e/QT ratio were calculated from ECG records. Tp-e intervals were measured with Tangent method, corrected Tp-e interval were measured with Bazett formula. Mean Tp-e interval results were as follows according to groups 1, 2, 3; 75.0±9.3, 88.1±7.0, 83.2±8.8 ms, respectively. The Tp-e interval, cTp-e interval, Tp- dispersion, QT interval, and SLI values were significantly higher in active cyclists than the veteran cyclists and the control group (p<0.05). Both cyclist groups had also significantly higher Tp-e interval, cTp-e interval, QT interval, Tp-e/QT, QRS time and SLI values than the control group (p<0.05). Furthermore, there were significant differences in Tp-e interval, cTp-e interval, Tp-e dispersion, QT interval and SLI values between the active and veteran cyclists (p<0.05). There were significant differences in Tp-e dispersion between active cyclists and control group or veteran cyclists (p< 0.01). Arrythmia related to Tp-e interval, Tp-e dispersion, corrected Tp-e interval and Tp-e/QT ratio are associated with long-term, intense bike sport training either in active cyclists or veterans. This can also be associated with left ventricular hypertrophy in active cyclists and remnant left ventricular hpertrophy in veterans.

References

  • Akıllı NB, Akıncı E, Akıllı H, Dündar ZD, Köylü R, Polat M, Cander B. A new marker for myocardial injury in carbonmonoxide poisoning: T peak–T end. American Journal of Emergency Medicine, 2013; 31: 1651–1655.
  • Alizade E, Avcı, A, Fidan S, Tabakçı M, Bulut M, Zehir R, Akçakoyun M. The effect of chronic anabolic–androgenic steroid use on Tp‐E interval, Tp‐E/Qt ratio, and Tp‐E/Qtc ratio in male bodybuilders. Annals of Noninvasive Electrocardiology, 2015; 20(6): 592-600.
  • Antzelevitch C. Tpeak–Tend interval as an index of transmural dispersion of repolarization. European journal of clinical investigation, 2001; 31(7): 555-557.
  • Baldesberger S, Bauersfeld U, Candinas R Seifert B, Zuber M, Ritter M, Jenni R, Oechslin E, Luthi P, Scharf C, Marti B, Attenhofer Jost CH. Sinus node disease and arrhythmias in the long-term follow-up of former professional cyclists. Eur Heart J, 2008; 29 (1): 71–78.
  • Braschi A, Francavilla VC, Abrignani MG, Todaro L, Francavilla G. Behavior of repolarization variables during exercise test in the athlete's heart. Annals of Noninvasive Electrocardiology, 2012; 17(2): 95-100.
  • Buchheıt M, Gındre C. Cardiac parasympathetic regulation: Respective associations with cardiorespiratory fitness and training load. Am J Physiol Heart Circ Physiol, 2006; 291(1): 451-458.
  • Devereux RB, Reichek N. Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method. Circulation, 1977; 55: 613–618.
  • Fagard R. Athlete’s heart. Heart, 2003; 89(12): 1455-1461.
  • Florescu M, Vınereanu D. How to differentiate athletes heart from pathological cardiac hypertrophy? Mædica A Journal of Clinical Medicine, 2006; 1: 19-26.
  • Gupta P, Patel C, Patel H, Narayanaswamy S, Malhotra B, Green JT, Yan GX. Tp-e/QT ratio as an index of arrhythmogenesis. Journal of Electrocardiology, 2008; (41): 567–574.
  • Hart G. Exercise induced hypertrophy: a substrate for sudden death in athletes? Experimental Physiology, 2003; 88(05): 639-644.
  • Heineke J, Molkentin JD. Regulation of cardiac hypertrophy by intracellular signalling pathways. Nature reviews Molecular cell biology, 2006; 7(8): 589-600.
  • Hevia JC, Antzelevitch C, Bárzaga FT, Sánchez MD, Balea FD, Molina RZ, Rodríguez, YF. T peak-T end and T peak-T end dispersion as risk factors for ventricular tachycardia/ventricular fibrillation in patients with the Brugada syndrome. Journal of the American College of Cardiology, 2006; 47(9): 1828-1834.
  • Hlaing T, Guo D, Zhao X, Di Mino T, Greenspon L, Kowey PR, Yan GX. The QT and Tpe intervals in left and right chest leads: comparison between patients with systemic and pulmonary hypertension. Journal of electrocardiology, 2005; 38(4): 154-158.
  • Hong L, Andersen LJ, Graff C, Vedel-Larsen E, Wang F, Struijk JJ, Kanters JK. T-wave morphology analysis of competitive athletes. Journal of electrocardiology, 2015; 48(1): 35-42.
  • Huston TP, Puffer JG, Mac Millan Rodney WM. The athletic heart syndrome. N Engl J Med, 1985; 313: 24–32.
  • Icli A, Kayrak M, Akilli H, Aribas A, Coskun M, Ozer SF, Ozdemir K. Prognostic value of Tpeak-Tend interval in patients with acute pulmonary embolism. BMC cardiovascular disorders, 2015; 15(1): 99.
  • Kayrak M, Acar K, Gul EE, Ozbek O, Abdulhalikov T, Sonmez O, Alibaşiç H. The association between myocardial iron load and ventricular repolarization parameters in asymptomatic beta-thalassemia patients. Adv Hematol, 2012; (2012): 170510.
  • Kiss O, Sydó N, Vargha P, Édes E, Merkely G, Sydó T, Merkely B. Prevalence of physiological and pathological electrocardiographic findings in Hungarian athletes. Acta Physiologica Hungarica, 2015; 102(2): 228-237.
  • Kreger BE, Cupples LA, Kannel WB. The electrocardiogram in prediction of sudden death: Framingham Study experience. American Heart Journal, 1987; 113(2): 377-382.
  • Lattanzi F, Di Bello V, Picano E, Caputo MT, Talarico L, Di Muro C, Distante A. Normal ultrasonic myocardial reflectivity in athletes with increased left ventricular mass. A tissue characterization study. Circulation, 1992; 85(5): 1828-1834.
  • Marcus R, Krause L, Weder AB, Dominguez-Meja A, Schork NJ, Julius S. Sex-specific determinants of increased left ventricular mass in the Tecumseh Blood Pressure Study. Circulation, 1994; 90: 928–936.
  • Maron BJ. Sudden death in young athletes. New England Journal of Medicine, 2003; 349(11): 1064-1075.
  • McCann GP, Muir DF, Hillis WS. Athletic left ventricular hypertrophy: Long-term studies are required. Eur Heart J, 2000; 21: 351–353.
  • McIntyre H, Fry CH. Abnormal action potential conduction in isolated human hypertrophied left ventricular myocardium. Journal of cardiovascular electrophysiology, 1997; 8(8): 887-894.
  • Mont L, Elosua R, Brugada J. Endurance sport practice as a risk factor for atrial fibrillation and atrial flutter. Europace, 2009; 11 (1): 11–17.
  • Morin DP, Saad MN, Shams OF, Owen JS, Xue JQ, Abi-Samra FM, Milani RV. Relationships between the T-peak to T-end interval, ventricular tachyarrhythmia, and death in left ventricular systolic dysfunction. Europace, 2012; 14: 1172-1179.
  • Omiya K, Sekizuka H, Kida K, Suzuki K, Akashi YJ, Ohba H, Musha H. Influence of gender and types of sports training on QT variables in young elite athletes. European Journal of Sport Science, 2014; 14(S1): 32-38.
  • Pavlik G, Major Z, Varga-Pinter B, Jeserich M, Kneffel Z: The athlete’s heart Part I (Review). Acta Physiol. Hung, 2010; 97: 337–353.
  • Pelliccia A, Di Paolo FM, Quattrini FM, Basso C, Culasso F, Popoli G, De Luca R, Spataro A, Biffi A, Thiene G, Maron BJ. Outcomes in athletes with marked ECG repolarization abnormalities. N Engl J Med, 2008; 358(2): 152–161.
  • Russo V, Ammendola E, De Crescenzo I, Ricciardi D, Capuano P, Topatino A, Docimo L, Santangelo L, Calabrò R. Effect of weight loss following bariatric surgery on myocardial dispersion of repolarization in morbidly obese patients. Obes Surg, 2007; 17(7): 857-86.
  • Sharashidze N, Pagava Z, Saatashvili G, Kishmarcia T, Agladze R. Exercise induced QT Dispersion changes in middle-aged veteran elite athletes. Georgian Med News, 2008; (157): 53-55.
  • Shimizu M, Ino H, Okeie K, Yamaguchi M, Nagata M, Hayashi K, Mabuchi H. T‐peak to T‐end interval may be a better predictor of high‐risk patients with hypertrophic cardiomyopathy associated with a cardiac troponin I mutation than QT dispersion. Clinical Cardiology, 2002; 25(7): 335-339.
  • Sorokin AV, Araujo CGS, Zweibel A, Thompson PD. Atrial fibrillation in endurance-trained athletes. Br J Sports Med, 2011; 45(3):185-188.
  • Tatlisu MA, Özcan KS, Güngör B, Ekmekçi A, Çekirdekçi EI, Arugarslan E, Erdinler I. Can the T-peak to T-end interval be a predictor of mortality in patients with ST-elevation myocardial infarction? Coronary Artery Disease, 2014; 25(5): 399-404.
  • Thompson PD. D. Bruce Dill. Historical lecture. Historical concepts of the athlete's heart. Medicine and Science in Sports and Exercise, 2004; 36(3): 363-370.
  • Whyte GP, Sheppard M, George KP, Shave RE, Wilson M, Stephens N, Senior R, Sharma S. Arrhythmias and the athlete: mechanisms and clinical significance. Eur Heart J, 2007; 28(11): 1399–1401 author reply 1401.
  • Yan GX, Rials SJ, Wu Y, Liu T, Xu X, Marinchak RA, Kowey PR. Ventricular hypertrophy amplifies transmural repolarization dispersion and induces early after depolarization. Am J Physiol Heart Circ Physiol, 2001; 281(5): 1968- 1975.
There are 38 citations in total.

Details

Journal Section Articles
Authors

Bulent Isık 0000-0001-8753-8302

Z. İsik Solak Gormus This is me 0000-0001-6762-6225

Huseyin Aslan This is me 0000-0003-2724-0445

Abdullah Iclı 0000-0002-7047-811X

Galip Bilen Kurklu 0000-0002-0200-529X

Ozgur Cıftcı This is me 0000-0002-6463-6070

Turhan Togan 0000-0002-5490-8888

Publication Date December 30, 2017
Acceptance Date November 10, 2017
Published in Issue Year 2017 Volume: 19 Issue: 3

Cite

APA Isık, B., Solak Gormus, Z. İ., Aslan, H., Iclı, A., et al. (2017). A novel marker to determine arrhytmia risk in elite cyclists: T peak T end. Turkish Journal of Sport and Exercise, 19(3), 313-321. https://doi.org/10.15314/tsed.369620
AMA Isık B, Solak Gormus Zİ, Aslan H, Iclı A, Kurklu GB, Cıftcı O, Togan T. A novel marker to determine arrhytmia risk in elite cyclists: T peak T end. Turk J Sport Exe. December 2017;19(3):313-321. doi:10.15314/tsed.369620
Chicago Isık, Bulent, Z. İsik Solak Gormus, Huseyin Aslan, Abdullah Iclı, Galip Bilen Kurklu, Ozgur Cıftcı, and Turhan Togan. “A Novel Marker to Determine Arrhytmia Risk in Elite Cyclists: T Peak T End”. Turkish Journal of Sport and Exercise 19, no. 3 (December 2017): 313-21. https://doi.org/10.15314/tsed.369620.
EndNote Isık B, Solak Gormus Zİ, Aslan H, Iclı A, Kurklu GB, Cıftcı O, Togan T (December 1, 2017) A novel marker to determine arrhytmia risk in elite cyclists: T peak T end. Turkish Journal of Sport and Exercise 19 3 313–321.
IEEE B. Isık, Z. İ. Solak Gormus, H. Aslan, A. Iclı, G. B. Kurklu, O. Cıftcı, and T. Togan, “A novel marker to determine arrhytmia risk in elite cyclists: T peak T end”, Turk J Sport Exe, vol. 19, no. 3, pp. 313–321, 2017, doi: 10.15314/tsed.369620.
ISNAD Isık, Bulent et al. “A Novel Marker to Determine Arrhytmia Risk in Elite Cyclists: T Peak T End”. Turkish Journal of Sport and Exercise 19/3 (December 2017), 313-321. https://doi.org/10.15314/tsed.369620.
JAMA Isık B, Solak Gormus Zİ, Aslan H, Iclı A, Kurklu GB, Cıftcı O, Togan T. A novel marker to determine arrhytmia risk in elite cyclists: T peak T end. Turk J Sport Exe. 2017;19:313–321.
MLA Isık, Bulent et al. “A Novel Marker to Determine Arrhytmia Risk in Elite Cyclists: T Peak T End”. Turkish Journal of Sport and Exercise, vol. 19, no. 3, 2017, pp. 313-21, doi:10.15314/tsed.369620.
Vancouver Isık B, Solak Gormus Zİ, Aslan H, Iclı A, Kurklu GB, Cıftcı O, Togan T. A novel marker to determine arrhytmia risk in elite cyclists: T peak T end. Turk J Sport Exe. 2017;19(3):313-21.

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