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Sanjay Sharma - One of the best experts on this subject based on the ideXlab platform.

  • Should axis deviation or Atrial Enlargement be categorised as abnormal in young athletes? the athlete's electrocardiogram: Time for re-appraisal of markers of pathology
    European heart journal, 2013
    Co-Authors: Sabiha Gati, Nabeel Sheikh, Saqib Ghani, Abbas Zaidi, Mathew G Wilson, Hariharan Raju, Andrew T Cox, Matthew Reed, Michael Papadakis, Sanjay Sharma
    Abstract:

    Aims The 2010 European Society of Cardiology (ESC) guidelines for electrocardiogram (ECG) interpretation in athletes are associated with a relatively high false positive rate and warrant modification to improve the specificity without compromising sensitivity. The aim of this study was to investigate whether non-specific anomalies such as axis deviation and Atrial Enlargement in isolation require further assessment in highly trained young athletes. Method and results Between 2003 and 2011, 2533 athletes aged 14–35 years were investigated with 12-lead ECG and echocardiography. Electrocardiograms were analysed for non-training-related (Group 2) changes according to the 2010 ESC guidelines. Results were compared with 9997 asymptomatic controls. Of the 2533 athletes, 329 (13%) showed Group 2 ECG changes. Isolated axis deviation and isolated Atrial Enlargement comprised 42.6% of all Group 2 changes. Athletes revealed a slightly higher prevalence of these anomalies compared with controls (5.5 vs. 4.4%; P = 0.023). Echocardiographic evaluation of athletes and controls with isolated axis deviation or Atrial Enlargement ( n = 579) failed to identify any major structural or functional abnormalities. Exclusion of axis deviation or Atrial Enlargement reduced the false positive rate from 13 to 7.5% and improved specificity from 90 to 94% with a minimal reduction in sensitivity (91–89.5%). Conclusion Isolated axis deviation and Atrial Enlargement comprise a high burden of Group 2 changes in athletes and do not predict underlying structural cardiac disease. Exclusion of these anomalies from current ESC guidelines would improve specificity and cost-effectiveness of pre-participation screening with ECG.

  • 062 Re-appraisal of ECG interpretation in young athletes: should axis deviation and voltage criterion for Atrial Enlargement be categorised as abnormal in athletes? The British experience
    Heart, 2012
    Co-Authors: Sabiha Gati, Nabeel Sheikh, Saqib Ghani, Abbas Zaidi, Matthew Reed, Michael Papadakis, N Von Nierkerk, L Chen, Sanjay Sharma
    Abstract:

    Purpose The European Society of Cardiology (ESC) guidelines for ECG interpretation in athletes facilitate the differentiation of physiological changes (Group 1) representing cardiac adaptation from those potentially associated with an increased cardiovascular risk (Group 2). Increased false positive rates remain the downside of electrocardiographic evaluation in athletes. The aim of this study was to assess whether axis deviation and Atrial Enlargement in isolation require further investigation in highly trained athletes. Methods Between 2003 and 2011, 1843 highly trained athletes (66% males) (mean age 20.7±6.0 years); range 14–35 years, underwent cardiac evaluation with 12-lead ECG and echocardiography. ECGs were analysed for training-unrelated changes, according to the ESC guidelines. Results Of the 1843 athletes, 1309 athletes (71%) demonstrated training related (Group 1) changes and 184 athletes (10%) exhibited training-unrelated (Group 2) changes. Of the Group 2 ECG changes, Atrial Enlargement and axis deviation in isolation were identified in 7.2% of athletes. Athletes with Atrial Enlargement or axis deviation did not exhibit significant difference in left ventricular end-diastolic cavity size >54 mm (35.6% vs 27.9% p=0.1005), mean right Atrial dimension (41.4 mm±5.6 mm vs 42.0 mm ±26.4 mm; p=0.848) or fractional shortening (2.5% vs 3.8%; p=0.7881) compared with athletes with Group 1 changes. The mean left Atrial dimension in athletes with Atrial Enlargement/axis deviation was greater than in athletes with Group 1 changes (35.6 mm ±5.58 mm vs 33.4 mm ±5.26 mm; p= 12 mm) (8.5% vs 3.1%; p=0.0209), right ventricular Enlargement (RVID1 >42 mm) (38.9% vs 29.4%; p=0.0412) compared with athletes with Group 1 changes. None of the athletes with axis deviation/Atrial Enlargement exhibited valve disease, or any features of hypertrophic cardiomyopathy or arrhythmogenic right ventricular cardiomyopathy. Conclusion Atrial Enlargement and axis deviation are relatively common in highly trained athletes. Subsequent investigation with echocardiography reveals slightly greater dimensions but has a low diagnostic yield for cardiac disease. Exclusion of these ECG parameters from the Group 2 category in asymptomatic athletes would reduce the false positive rate from 10% to an acceptable

Ludger Grote - One of the best experts on this subject based on the ideXlab platform.

  • association between left Atrial Enlargement and obstructive sleep apnea in a general population of 71 year old men
    Journal of Sleep Research, 2018
    Co-Authors: Henrik Holtstrand Hjälm, Per-olof Hansson, You Zhong, Kenneth Caidahl, Zacharias Mandalenakis, David Morales, Constantinos Ergatoudes, Annika Rosengren, Ludger Grote, Erik Thunstrom
    Abstract:

    Left Atrial Enlargement has been shown to be associated with obstructive sleep apnea in patients with coronary artery disease and in sleep clinic cohorts. However, data from the general population are limited. The aim of this study was to investigate whether there is an association between obstructive sleep apnea and left Atrial Enlargement in a random sample from a general population of 71-year-old men. As part of the longitudinal population study The Study of Men Born in 1943, we analysed cross-sectional data for 411 men, all 71 years old, who had participated in an overnight home sleep study and a standardized echocardiographic examination. Of the 411 men, 29.4% had moderate to severe obstructive sleep apnea [apnea-hypopnea index score of ≥15 (n = 121)]. These participants showed a significantly higher frequency of systolic heart failure, hypertension, overweight, had greater waist circumference as well as higher left Atrial areas compared with men with no or mild obstructive sleep apnea (23.7 ± 5.5 cm2 versus 21.6 ± 4.5 cm2 , P < 0.001). In a linear regression analysis, obstructive sleep apnea was significantly associated with left Atrial Enlargement after adjusting for overweight, Atrial fibrillation, heart failure with reduced ejection fraction, hypertension and mitral regurgitation. Compared with individuals without obstructive sleep apnea, the mean left Atrial area was 1.7 ± 1.5 cm2 larger in men with severe obstructive sleep apnea (P < 0.05) and 1.3 ± 1.1 cm2 larger among men with moderate obstructive sleep apnea (P < 0.05). In this cross-sectional study of 71-year-old men from the general population, left Atrial area was independently associated with prevalence and severity of obstructive sleep apnea.

  • Association between left Atrial Enlargement and obstructive sleep apnea in a general population of 71‐year‐old men
    Journal of sleep research, 2017
    Co-Authors: Henrik Holtstrand Hjälm, Per-olof Hansson, You Zhong, Kenneth Caidahl, Zacharias Mandalenakis, David Morales, Constantinos Ergatoudes, Annika Rosengren, Ludger Grote
    Abstract:

    Left Atrial Enlargement has been shown to be associated with obstructive sleep apnea in patients with coronary artery disease and in sleep clinic cohorts. However, data from the general population are limited. The aim of this study was to investigate whether there is an association between obstructive sleep apnea and left Atrial Enlargement in a random sample from a general population of 71-year-old men. As part of the longitudinal population study The Study of Men Born in 1943, we analysed cross-sectional data for 411 men, all 71 years old, who had participated in an overnight home sleep study and a standardized echocardiographic examination. Of the 411 men, 29.4% had moderate to severe obstructive sleep apnea [apnea-hypopnea index score of ≥15 (n = 121)]. These participants showed a significantly higher frequency of systolic heart failure, hypertension, overweight, had greater waist circumference as well as higher left Atrial areas compared with men with no or mild obstructive sleep apnea (23.7 ± 5.5 cm2 versus 21.6 ± 4.5 cm2 , P < 0.001). In a linear regression analysis, obstructive sleep apnea was significantly associated with left Atrial Enlargement after adjusting for overweight, Atrial fibrillation, heart failure with reduced ejection fraction, hypertension and mitral regurgitation. Compared with individuals without obstructive sleep apnea, the mean left Atrial area was 1.7 ± 1.5 cm2 larger in men with severe obstructive sleep apnea (P < 0.05) and 1.3 ± 1.1 cm2 larger among men with moderate obstructive sleep apnea (P < 0.05). In this cross-sectional study of 71-year-old men from the general population, left Atrial area was independently associated with prevalence and severity of obstructive sleep apnea.

Sabiha Gati - One of the best experts on this subject based on the ideXlab platform.

  • Should axis deviation or Atrial Enlargement be categorised as abnormal in young athletes? the athlete's electrocardiogram: Time for re-appraisal of markers of pathology
    European heart journal, 2013
    Co-Authors: Sabiha Gati, Nabeel Sheikh, Saqib Ghani, Abbas Zaidi, Mathew G Wilson, Hariharan Raju, Andrew T Cox, Matthew Reed, Michael Papadakis, Sanjay Sharma
    Abstract:

    Aims The 2010 European Society of Cardiology (ESC) guidelines for electrocardiogram (ECG) interpretation in athletes are associated with a relatively high false positive rate and warrant modification to improve the specificity without compromising sensitivity. The aim of this study was to investigate whether non-specific anomalies such as axis deviation and Atrial Enlargement in isolation require further assessment in highly trained young athletes. Method and results Between 2003 and 2011, 2533 athletes aged 14–35 years were investigated with 12-lead ECG and echocardiography. Electrocardiograms were analysed for non-training-related (Group 2) changes according to the 2010 ESC guidelines. Results were compared with 9997 asymptomatic controls. Of the 2533 athletes, 329 (13%) showed Group 2 ECG changes. Isolated axis deviation and isolated Atrial Enlargement comprised 42.6% of all Group 2 changes. Athletes revealed a slightly higher prevalence of these anomalies compared with controls (5.5 vs. 4.4%; P = 0.023). Echocardiographic evaluation of athletes and controls with isolated axis deviation or Atrial Enlargement ( n = 579) failed to identify any major structural or functional abnormalities. Exclusion of axis deviation or Atrial Enlargement reduced the false positive rate from 13 to 7.5% and improved specificity from 90 to 94% with a minimal reduction in sensitivity (91–89.5%). Conclusion Isolated axis deviation and Atrial Enlargement comprise a high burden of Group 2 changes in athletes and do not predict underlying structural cardiac disease. Exclusion of these anomalies from current ESC guidelines would improve specificity and cost-effectiveness of pre-participation screening with ECG.

  • 062 Re-appraisal of ECG interpretation in young athletes: should axis deviation and voltage criterion for Atrial Enlargement be categorised as abnormal in athletes? The British experience
    Heart, 2012
    Co-Authors: Sabiha Gati, Nabeel Sheikh, Saqib Ghani, Abbas Zaidi, Matthew Reed, Michael Papadakis, N Von Nierkerk, L Chen, Sanjay Sharma
    Abstract:

    Purpose The European Society of Cardiology (ESC) guidelines for ECG interpretation in athletes facilitate the differentiation of physiological changes (Group 1) representing cardiac adaptation from those potentially associated with an increased cardiovascular risk (Group 2). Increased false positive rates remain the downside of electrocardiographic evaluation in athletes. The aim of this study was to assess whether axis deviation and Atrial Enlargement in isolation require further investigation in highly trained athletes. Methods Between 2003 and 2011, 1843 highly trained athletes (66% males) (mean age 20.7±6.0 years); range 14–35 years, underwent cardiac evaluation with 12-lead ECG and echocardiography. ECGs were analysed for training-unrelated changes, according to the ESC guidelines. Results Of the 1843 athletes, 1309 athletes (71%) demonstrated training related (Group 1) changes and 184 athletes (10%) exhibited training-unrelated (Group 2) changes. Of the Group 2 ECG changes, Atrial Enlargement and axis deviation in isolation were identified in 7.2% of athletes. Athletes with Atrial Enlargement or axis deviation did not exhibit significant difference in left ventricular end-diastolic cavity size >54 mm (35.6% vs 27.9% p=0.1005), mean right Atrial dimension (41.4 mm±5.6 mm vs 42.0 mm ±26.4 mm; p=0.848) or fractional shortening (2.5% vs 3.8%; p=0.7881) compared with athletes with Group 1 changes. The mean left Atrial dimension in athletes with Atrial Enlargement/axis deviation was greater than in athletes with Group 1 changes (35.6 mm ±5.58 mm vs 33.4 mm ±5.26 mm; p= 12 mm) (8.5% vs 3.1%; p=0.0209), right ventricular Enlargement (RVID1 >42 mm) (38.9% vs 29.4%; p=0.0412) compared with athletes with Group 1 changes. None of the athletes with axis deviation/Atrial Enlargement exhibited valve disease, or any features of hypertrophic cardiomyopathy or arrhythmogenic right ventricular cardiomyopathy. Conclusion Atrial Enlargement and axis deviation are relatively common in highly trained athletes. Subsequent investigation with echocardiography reveals slightly greater dimensions but has a low diagnostic yield for cardiac disease. Exclusion of these ECG parameters from the Group 2 category in asymptomatic athletes would reduce the false positive rate from 10% to an acceptable

Henrik Holtstrand Hjälm - One of the best experts on this subject based on the ideXlab platform.

  • association between left Atrial Enlargement and obstructive sleep apnea in a general population of 71 year old men
    Journal of Sleep Research, 2018
    Co-Authors: Henrik Holtstrand Hjälm, Per-olof Hansson, You Zhong, Kenneth Caidahl, Zacharias Mandalenakis, David Morales, Constantinos Ergatoudes, Annika Rosengren, Ludger Grote, Erik Thunstrom
    Abstract:

    Left Atrial Enlargement has been shown to be associated with obstructive sleep apnea in patients with coronary artery disease and in sleep clinic cohorts. However, data from the general population are limited. The aim of this study was to investigate whether there is an association between obstructive sleep apnea and left Atrial Enlargement in a random sample from a general population of 71-year-old men. As part of the longitudinal population study The Study of Men Born in 1943, we analysed cross-sectional data for 411 men, all 71 years old, who had participated in an overnight home sleep study and a standardized echocardiographic examination. Of the 411 men, 29.4% had moderate to severe obstructive sleep apnea [apnea-hypopnea index score of ≥15 (n = 121)]. These participants showed a significantly higher frequency of systolic heart failure, hypertension, overweight, had greater waist circumference as well as higher left Atrial areas compared with men with no or mild obstructive sleep apnea (23.7 ± 5.5 cm2 versus 21.6 ± 4.5 cm2 , P < 0.001). In a linear regression analysis, obstructive sleep apnea was significantly associated with left Atrial Enlargement after adjusting for overweight, Atrial fibrillation, heart failure with reduced ejection fraction, hypertension and mitral regurgitation. Compared with individuals without obstructive sleep apnea, the mean left Atrial area was 1.7 ± 1.5 cm2 larger in men with severe obstructive sleep apnea (P < 0.05) and 1.3 ± 1.1 cm2 larger among men with moderate obstructive sleep apnea (P < 0.05). In this cross-sectional study of 71-year-old men from the general population, left Atrial area was independently associated with prevalence and severity of obstructive sleep apnea.

  • Association between left Atrial Enlargement and obstructive sleep apnea in a general population of 71‐year‐old men
    Journal of sleep research, 2017
    Co-Authors: Henrik Holtstrand Hjälm, Per-olof Hansson, You Zhong, Kenneth Caidahl, Zacharias Mandalenakis, David Morales, Constantinos Ergatoudes, Annika Rosengren, Ludger Grote
    Abstract:

    Left Atrial Enlargement has been shown to be associated with obstructive sleep apnea in patients with coronary artery disease and in sleep clinic cohorts. However, data from the general population are limited. The aim of this study was to investigate whether there is an association between obstructive sleep apnea and left Atrial Enlargement in a random sample from a general population of 71-year-old men. As part of the longitudinal population study The Study of Men Born in 1943, we analysed cross-sectional data for 411 men, all 71 years old, who had participated in an overnight home sleep study and a standardized echocardiographic examination. Of the 411 men, 29.4% had moderate to severe obstructive sleep apnea [apnea-hypopnea index score of ≥15 (n = 121)]. These participants showed a significantly higher frequency of systolic heart failure, hypertension, overweight, had greater waist circumference as well as higher left Atrial areas compared with men with no or mild obstructive sleep apnea (23.7 ± 5.5 cm2 versus 21.6 ± 4.5 cm2 , P < 0.001). In a linear regression analysis, obstructive sleep apnea was significantly associated with left Atrial Enlargement after adjusting for overweight, Atrial fibrillation, heart failure with reduced ejection fraction, hypertension and mitral regurgitation. Compared with individuals without obstructive sleep apnea, the mean left Atrial area was 1.7 ± 1.5 cm2 larger in men with severe obstructive sleep apnea (P < 0.05) and 1.3 ± 1.1 cm2 larger among men with moderate obstructive sleep apnea (P < 0.05). In this cross-sectional study of 71-year-old men from the general population, left Atrial area was independently associated with prevalence and severity of obstructive sleep apnea.

Erik Thunstrom - One of the best experts on this subject based on the ideXlab platform.

  • association between left Atrial Enlargement and obstructive sleep apnea in a general population of 71 year old men
    Journal of Sleep Research, 2018
    Co-Authors: Henrik Holtstrand Hjälm, Per-olof Hansson, You Zhong, Kenneth Caidahl, Zacharias Mandalenakis, David Morales, Constantinos Ergatoudes, Annika Rosengren, Ludger Grote, Erik Thunstrom
    Abstract:

    Left Atrial Enlargement has been shown to be associated with obstructive sleep apnea in patients with coronary artery disease and in sleep clinic cohorts. However, data from the general population are limited. The aim of this study was to investigate whether there is an association between obstructive sleep apnea and left Atrial Enlargement in a random sample from a general population of 71-year-old men. As part of the longitudinal population study The Study of Men Born in 1943, we analysed cross-sectional data for 411 men, all 71 years old, who had participated in an overnight home sleep study and a standardized echocardiographic examination. Of the 411 men, 29.4% had moderate to severe obstructive sleep apnea [apnea-hypopnea index score of ≥15 (n = 121)]. These participants showed a significantly higher frequency of systolic heart failure, hypertension, overweight, had greater waist circumference as well as higher left Atrial areas compared with men with no or mild obstructive sleep apnea (23.7 ± 5.5 cm2 versus 21.6 ± 4.5 cm2 , P < 0.001). In a linear regression analysis, obstructive sleep apnea was significantly associated with left Atrial Enlargement after adjusting for overweight, Atrial fibrillation, heart failure with reduced ejection fraction, hypertension and mitral regurgitation. Compared with individuals without obstructive sleep apnea, the mean left Atrial area was 1.7 ± 1.5 cm2 larger in men with severe obstructive sleep apnea (P < 0.05) and 1.3 ± 1.1 cm2 larger among men with moderate obstructive sleep apnea (P < 0.05). In this cross-sectional study of 71-year-old men from the general population, left Atrial area was independently associated with prevalence and severity of obstructive sleep apnea.