Electrocardiographic and echocardiographic predictors of greater carotid intima‐media thickness in tactical athletes: The CHIEF atherosclerosis study

Author:

Lin Yen‐Po123,Hsu Yi‐Chiung1,Tsai Kun‐Zhe45,Huang Wei‐Chun67,Han Chih‐Lu8,Lin Gen‐Min19ORCID

Affiliation:

1. Department of Biomedical Sciences & Engineering National Central University Taoyuan Taiwan

2. Department of Medicine Hualien Armed Forces General Hospital Hualien Taiwan

3. Department of Critical Care Medicine Taipei Tzu Chi General Hospital New Taipei City Taiwan

4. Department of Stomatology of Periodontology Mackay Memorial Hospital Taipei Taiwan

5. Department of Dentistry Tri‐Service General Hospital, National Defense Medical Center Taipei Taiwan

6. College of Medicine National Yang Ming Chiao Tung University Taipei Taiwan

7. Department of Critical Care Medicine Kaohsiung Veterans General Hospital Kaohsiung Taiwan

8. Department of Internal Medicine Taipei Veterans General Hospital Taipei Taiwan

9. Department of Medicine Tri‐Service General Hospital and National Defense Medical Center Taipei Taiwan

Abstract

AbstractObjectiveBoth electrocardiographic and echocardiographic left ventricular hypertrophy (LVH) have been reported with an association with greater carotid intima‐media thickness (cIMT), a marker of subclinical atherosclerosis in patients with hypertension, while the associations are unclear in physically fit young adults.MethodsA total of 1822 Taiwanese military personnel, aged 18–40 years, received an annual health examination including electrocardiography (ECG) and echocardiography in 2018–2020. Left carotid bulb cIMT was measured by high‐resolution ultrasonography. Multiple logistic regression analysis with adjustments for age, sex, smoking, alcohol consumption, body mass index, mean blood pressure, and physical fitness was used to determine the associations between echocardiographic and ECG parameters and the highest quintile of cIMT (≥0.8 mm).ResultsCornell‐based LVH, Myers et al.‐based RVH and heart rate ≥75/min were associated with cIMT ≥0.8 mm [odds ratios (ORs) and 95% confidence intervals: 1.54 (1.01, 2.35), 1.66 (1.18, 2.33), and 1.39 (1.06, 1.83), respectively], while echocardiographic LVH defined as ≥46.0 g/m2.7 for men and ≥38.0 g/m2.7 for women was inversely associated with cIMT ≥0.8 mm [OR: 0.45 (0.24, 0.86)].ConclusionIn tactical athletes of military, the associations of ECG and echocardiographic LVH with cIMT were in opposite directions. Higher physical fitness may cause cardiac muscle hypertrophy and reduce the atherosclerosis severity, possibly leading to the paradoxical echocardiographic finding. This study suggests that ECG‐based LVH remains a good marker of subclinical atherosclerosis in our military population.

Funder

Medical Affairs Bureau

Publisher

Wiley

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine,General Medicine

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