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  • Title: Spectrum of ST amplitude: athletes and an ambulatory clinical population.
    Author: Muramoto D, Singh N, Aggarwal S, Wong M, Adhikarla C, Hadley D, Froelicher V.
    Journal: J Electrocardiol; 2013; 46(5):427-33. PubMed ID: 23866295.
    Abstract:
    BACKGROUND AND PURPOSE: To augment data guiding thresholds for myocardial ischemia and cardiac risk, we studied resting ST amplitude in ambulatory patients and collegiate athletes. METHODS: We analyzed 4041 ECGs from ambulatory visits at the Veterans Affairs in Palo Alto, California from 1997 to 1999 and 1114 screening ECGs from Stanford University athletes in 2007-2008. Using the PR interval as the isoelectric line and >95μV and<-45μV (visually equivalent to 1mm and 0.5mm) to define ST elevation and depression, ST amplitude was measured at QRS-end. RESULTS: ST elevation was most prevalent in males, African Americans, and athletes (87% of male athletes in anterior leads). ST depression was rare in athletes and, among patients, associated with time to cardiovascular death in lateral leads (age-adjusted HR of 1.9, p<0.001). CONCLUSIONS: ST amplitude differs by gender, age, race, and athletic status, which should be considered when developing guidelines for ECG interpretation.
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