T-Wave Inversion on ECG: A Predictor of Cardiac Disease?

An international group of investigators conducted a study to assess the value of adding genetic testing to the clinical evaluation of athletes with T-wave inversion (TWI) noted at preparticipation ECG screening. For the study, they enrolled 50 consecutive athletes of African or Afro-Caribbean descent (black athletes) and 50 consecutive white athletes referred to a tertiary sports cardiology center in the United Kingdom. Only athletes without a history of cardiac disease and a normal cardiac echocardiogram were enrolled. TWI >-0.1 mV in 2 or more contiguous leads was considered significant. TWI was defined as anterior (present in leads V1–V4), inferior (leads II, III, aVF), or lateral (leads I, aVL, V5, V6). Clinical evaluation of referred athletes included ECG, signal-averaged ECG, cardiopulmonary exercise stress testing, 24-hour ambulatory ECG monitoring, …