P3244The mixed race heart: not so black and white

Abstract

Background: The past 2 decades has seen a huge rise in the number of mixed race athletes with one white and one black parent. In fact this is the largest growing ethnic group in both Europe and the USA. Little is known on the cardiac adaptations of mixed race athletes. This is the first study to analyse the ECGs and echocardiograms of mixed race athletes (MAs) and compare them to white (WAs) and black (BAs) athletes. Method(s): 10,160 ECGs and echocardiograms were studied. 465 mixed race professional male soccer players were compared to 953 black and 9,162 white soccer players all of whom underwent mandatory preparticipation screening with EKG and echocardiogram. All MAs had one white and one black parent. EKG and echocardiogram characteristics max. left ventriculat wall thickness, MLVWT and left ventricular end diastolic diamter, LVEDD) were analysed independently by 2 cardiologists. Result(s): The mean age of the athletes was 16.7 years. 95% were male. ECG findings: MAs had a higher prevalence of bradycardia (67%) vs. both WAs (44%) and BAs (46%; table 1). They also had more left ventricular hypertrophy (30%) vs. BAs (17%). MAs revealed more atrial enlargement and left axis deviation than WAs, but not BAs. T wave inversion (TWI) was 4 times more common in MAs (8%) than WAs (2.3%) though less common than BAs (10.9%). Echocardiogram findings: * Black male athletes exhibited a greater MLVWT than white athetes (10.94 vs. 10.59mm; p<0.0001) and mixed race athletes (10.94 vs. 10.75mm; p=0.0323). Mixed race athletes revealed a greater MLVWT than white athletes (10.75 vs. 10.59mm; p=0.0323). (Figure) * White male athletes demonstrated the largest LV cavity sizes compared to black athletes (52.44 vs. 50.6mm; p<0.0001) and compared to mixed race athletes (52.55 vs. 51.05mm; p<0.0001). (figure) (Figure Presented) Conclusion(s): Mixed race athletes revealed ECG characteristics that were more similar in terms of prevalence to black athletes than white athletes. There were no significant differences in terms of prevalence of left atrial enlargement, right atrial enlargement, left axis deviation and right axis deviation. When mixed race athletes were compared to white athletes, these ECG findings were all significantly lower in white athletes, suggesting that mixed race adolescent athlete exhibit socalled "borderline" ECG changes in a similar pattern to black rather than white adolescent athletes. The parameters MLVWT and LVEDD for the mixed race athlete seem to fall in between white and black ethnic groups, though the mixed race athlete tends to exhibit ECG and structural adaptations more similar to black athletes than white athletes.