| Abstract ID |
| 20260101 |
| Category |
| Sports Medicine: Sports Cardiology |
| Preferable Presentation |
| Oral Presentation |
| Title |
| CARDIAC REMODELLING IN ELITE FOOTBALLERS: IMPLICATIONS FOR ECG SCREENING CRITERIA |
| Author |
|
| Presenter |
| ThiAGARAJAN ALWAR |
| Abstract |
| Cardiac Remodelling in Elite Footballers: Implications for ECG Screening Criteria K A Thiagarajan, Nithila Sundresh, Sai Aditya Raman, Rohit K R, Arumugam S Sri Ramachandra Centre for Sports Science Sri Ramachandra Institute of Higher Education and Research, Chennai, India ABSTRACT Background & Objective Electrocardiography (ECG) is a gold standard screening tool in pre-participation screening for prevention of sudden cardiac death. While current international criteria account for age and ethnicity, they may overlook sport specific demands such as player role/positional variations. In football, defenders manage high volume aerobic loads, while strikers perform frequent high intensity anaerobic bursts. These distinct hemodynamic stressors could induce differential electrical remodelling, specifically ventricular depolarization. Increased match frequency with longer seasons may also contribute to electrical changes. This study aims to determine the influence of player role and increased match frequency on key ECG variables. Methods After obtaining informed consent, a cross-sectional analysis of the ECGs of 91 elite male professional football players, who underwent pre-competition medical screening at a private sports medicine facility, was done. Resting 12-lead ECGs were analysed for Heart Rate, PR interval, QRS duration, and QTc interval. Players were stratified by position and divided based on microcycle load preceding screening into two groups: 1 match/week and 2 matches/week. Statistical analysis included One-Way Analysis of Variance with Fisher’s Least Significant Difference post-hoc testing and Independent Samples T-tests, with 0.05 as significance level. Results Demographic distribution of the 91 players showed a mean age 23.1 years, with 31 Defenders, 29 Midfielders, 19 Strikers and 12 Goalkeepers. 57 players had a match frequency of 1 match/week and 34 players had a match frequency of 2 matches/week. Players demonstrated normal athletic cardiac adaptations with a mean resting heart rate of 58 beats per minute. Global comparisons showed no statistically significant differences across all four groups. Post-hoc analysis revealed a distinct electrophysiological phenotype in Strikers, exhibiting a significantly prolonged QRS duration (106.54± 9.35ms) compared to Defenders (97.27± 10.46ms) (p=0.019). This 9.3ms difference signifies a distinct depolarisation delay in forwards. Conversely, repolarisation (QTc) and atrioventricular conduction (PR) were stable across all positions. There were no significant differences in Heart Rate, PR, QRS, or QTc intervals between the 1 match/week and 2 matches/ week groups. Conclusions Elite football players exhibit some position-specific cardia remodelling. Strikers seem to develop a distinct prolonged ventricular depolarization compared to the defenders. Borderline QRS prolongation in strikers may thus represent a physiological adaptation to high-intensity anaerobic load rather than conduction pathology. This finding calls for further investigation to develop position specific ECG criteria for pre-competition screening in football. Furthermore, electrocardiographic variables did not change with match frequency, suggesting that the current timing of pre-participation screening could be sufficient, with no need for an additional mid-season screening. Keywords: PCMA, Football, Electrocardiography, Sudden Cardiac Death, Prevention |