SOME of the world鈥檚 fittest men and women will perform at the Olympics in
September. But even these elite athletes can鈥檛 discount the threat of heart
disease at some time in their lives. And their unusually large hearts may
disguise the symptoms, research in Italy suggests.
Antonio Pelliccia, of the Institute of Sports Science in Rome, has studied
the routine electrocardiograms (ECGs) of 1005 athletes from the Italian Olympic
squad. He found that 40 per cent had a type of abnormal ECG that often reveals
problems leading to premature heart failure.
Pelliccia says that in most cases these abnormalities are due to the
athletes鈥� intensive training, which causes the heart to increase in size,
especially among those taking part in endurance events such as cycling and
running.
Advertisement
The concern is that if such ECGs are interpreted as 鈥渘ormal for athletes鈥� it
may be difficult to pick out those who really do have heart problems. 鈥淚t makes
managing athletes by ECG very difficult,鈥� Pellicia told 快猫短视频.
Using ultrasound scans to produce an image of the heart, he was able to show
that the vast majority of athletes with abnormal ECGs had no problems. But 5 per
cent had heart defects, mainly in their heart valves, that would not have been
spotted from the ECG alone, he reports in a forthcoming issue of
Circulation. Pelliccia believes that these valve defects, which are linked
to the left ventricle, may result from the athletes鈥� intensive training.
An enlarged heart is sometimes a sign of an inherited disease, congenital
hypertrophic cardiomyopathy, which affects 1 in 1000 people and causes illness
or death in young adults. Young athletes are no less prone to the disease than
anyone else. 鈥淚t鈥檚 a nightmare for cardiologists,鈥� says Philip Poole-Wilson of
London鈥檚 Imperial College School of Medicine. 鈥淭he problem is, how do you
distinguish between this and 鈥榓thlete鈥檚 heart鈥�, in which the heart is healthy
and large from training?鈥�
The other side of the problem, say sports doctors, is that misleading ECGs
might discourage athletes from training when in fact they are perfectly healthy.
Nick Webborn, medical director of Britain鈥檚 National Sports Medicine Institute,
says: 鈥淭he last thing we need is for doctors to stop athletes training when
there may not be a problem.鈥�