Echocardiographic and ambulatory electrocardiographic findings in elite water-polo athletes

The aim of this study was to investigate the echocardiographic and electroc ardiographic findings in top water-polo athletes and test the hypothesis th at their hearts exhibit dilatation associated with hypertrophy secondary to the mixed type (isotonic and isometric) of exercise they are subjected to. Eighteen athletes of the Greek national water-polo team and 15 healthy sed entary men serving as controls were studied. All underwent an echocardiogra m, a standard 12-lead ECG and 24-h ECG monitoring. In athletes, as compared to healthy controls, an increase was detected in the following indices: le ft ventricular (LV) end-diastolic diameter index (EDDI-LV) (by 10%; P=0.02) , interventricular septal thickness (IVS) (by 32%; P <0.001), thickness of the posterior wall (PW) (by 29%; P<0.001), relative wall thickness (IVS+PW/ EDD-LV) (by 12%; P<less than>0.001) and LV mass index (by 82%; P<0.001). Mi ld asymmetric thickening of the septum (IVS/PW=1.40 and 1.37) was measured in two athletes. LV fractional shortening was normal. Standard 12-lead ECG abnormalities (LV hypertrophy or abnormal repolarization pattern) were obse rved in 33% of athletes. Athletes had sinus bradycardia during day and nigh t, respiratory arrhythmia (RA) (83% vs 40% of controls; P=0.03) and sinus p auses (SP) (39% vs 0% of controls; P=0.02), with occassional arrhythmias an d conduction abnormalities. We conclude that top water-polo athletes have d ilatation combined with substantial hypertrophy and normal systolic functio n of the LV In addition they present bradycardia, RA and SP, with occassion al arrhythmias and conduction abnormalities.