Dynamic Echocardiographic Changes Induced by Exercise in Healthy, Young Individuals with Early Repolarization Pattern

TL;DR

This study found that young, healthy individuals with early repolarization pattern show unique heart volume changes after exercise, but no structural heart issues.

Contribution

The study reveals distinct volumetric heart responses to exercise in ERP+ individuals without structural abnormalities.

Findings

ERP+ individuals showed greater reductions in left ventricular end-diastolic volume after exercise.

No structural or functional heart abnormalities were found in ERP+ individuals.

ERP+ and ERP− groups had similar cardiovascular fitness and pressor responses to exercise.

Abstract

Background: The early repolarization pattern (ERP) on electrocardiography (ECG) has been associated with an increased risk of ventricular arrhythmias in susceptible individuals. This study aimed to evaluate the impact of exercise on echocardiographic parameters to explore the potential influence of ERP on hemodynamic response. Methods: Twenty-five healthy, young males with ERP (ERP+ group) and 25 age-matched healthy males without ERP (ERP− group) were enrolled. Comprehensive transthoracic echocardiography was performed at rest and during the early recovery phase following a treadmill exercise test. Baseline values and exercise-induced changes in both conventional and strain-derived echocardiographic parameters were analyzed and compared between groups. Results: Anthropometric measures and resting vital signs were similar in both groups. At baseline, the ERP+ group had a shorter QRS duration. Both groups demonstrated excellent cardiovascular fitness, with comparable chronotropic and pressor responses to exercise. Resting and early recovery-phase echocardiographic parameters were largely similar between ERP+ and ERP− individuals, with no overt structural or functional abnormalities observed in either group. However, ERP+ individuals showed significantly greater reductions in left ventricular end-diastolic volume and stroke volume following exercise, suggesting a distinct volumetric response to physical stress. Conclusions: ERP in healthy young males is not associated with structural cardiac abnormalities or overt myocardial dysfunction. The observed exercise-induced volumetric changes may indicate subtle differences in hemodynamic adaptation, warranting further investigation.

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