COMPARISON OF 12-LEAD REPOLARIZATION PARAMETERS DURING FOLLOW-UP-STUDY IN MIDDLE-AGED SPORTSMEN AND IN PATIENTS DURING ACUTE MYOCARDIAL-INFARCTION

Consecutive electrocardiographic (EGG) analysis is very useful in acut e coronary ischemia, but it is known that ECG patterns can be misleadi ng in subjects with left ventricular hypertrophy, mainly during the re polarization phase. An automated system was developed to collect, stor e, and follow-up all heterogeneous data concerning a cohort of 1,898 s ubjects (1,039 men), 45-65 years old, 50% of whom were physically acti ve. The reliability of several ECG markers of ischemia was tested duri ng chronic follow-up study (1993-1995) in 23 healthy, sedentary men wi thout hypertension (group 1) recorded in our database, as well as in 9 subjects performing regular sporting activity (SA) (group 2). The sam e parameters were evaluated in the intensive care unit in nine patient s affected by coronary artery disease, during either successful or uns uccessful thrombolytic therapy of acute myocardial infarction (AMI) (g roup 3). Twelve-lead ECGs were recorded, analyzed by the Hannover ECG system program, compressed, and stored according to the Standard Commu nication Protocol in each of the three groups. The changes in ST ampli tude 20, 60, and 80 ms after the J point were very small in each subje ct of groups 1 and 2, while upsloping from 1 to 10 mm in several leads was observed slowly, rapidly, or intermittently in group 3 patients d uring ischemia. The ST slope and the concordance of the T wave and ST amplitude were helpful in differentiating normal and SA subjects from AMI patients. These results, obtained in resting conditions, underline that the difference among ST-T abnormalities in subjects with left ve ntricular hypertrophy due to SA are consistently different from those observed in patients with AMI. The serial digital ECG can be helpful t o underline these differences.