Work

Race- and Sex-Associated Electrocardiographic Repolarization Characteristics in Young American Athletes in the Digital Age

Year: 2025

Type: article

Abstract: BACKGROUND: The 2017 International Criteria for electrocardiographic (ECG) Interpretation in athletes include differential interpretation of anterior T-wave inversion (TWI) based on sex and race. OBJECTIVES: The purpose of this study was to analyze race- and sex-associated TWI differences and T-wave amplitudes in a digital ECG database of American athletes. METHODS: . RESULTS: , II, and aVF was more common in Black than non-Black athletes. The convex anterior TWI pattern was rare overall (0.26%, n = 23), without sex- or race-associated differences (0.25% Black vs 0.27% non-Black athletes; P = 1.00). T-wave amplitude was associated with male sex and lower heart rate but not race. CONCLUSIONS: Anterior TWIs are common in young American athletes, with sex differences but minimal racial variation. The similar prevalence of the convex anterior TWI pattern suggests this pattern may be a normal finding in all races. Our findings offer digital reference values that may refine future ECG screening guidelines.

Source: JACC Advances

DOI: 10.1016/j.jacadv.2025.102409