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Relating QRS voltages to left ventricular mass and body composition in elite endurance athletes

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Abstract
Purpose Electrocardiogram (ECG) QRS voltages correlate poorly with left ventricular mass (LVM). Body composition explains some of the QRS voltage variability. The relation between QRS voltages, LVM and body composition in endurance athletes is unknown. Methods Elite endurance athletes from the Pro@Heart trial were evaluated with 12-lead ECG for Cornell and Sokolow-Lyon voltage and product. Cardiac magnetic resonance imaging assessed LVM. Dual energy x-ray absorptiometry assessed fat mass (FM) and lean mass of the trunk and whole body (LBM). The determinants of QRS voltages and LVM were identified by multivariable linear regression. Models combining ECG, demographics, DEXA and exercise capacity to predict LVM were developed. Results In 122 athletes (19 years, 71.3% male) LVM was a determinant of the Sokolow-Lyon voltage and product (beta = 0.334 and 0.477, p < 0.001) but not of the Cornell criteria. FM of the trunk (beta = - 0.186 and - 0.180, p < 0.05) negatively influenced the Cornell voltage and product but not the Sokolow-Lyon criteria. DEXA marginally improved the prediction of LVM by ECG (r = 0.773 vs 0.510, p < 0.001; RMSE = 18.9 +/- 13.8 vs 25.5 +/- 18.7 g, p > 0.05) with LBM as the strongest predictor (beta = 0.664, p < 0.001). DEXA did not improve the prediction of LVM by ECG and demographics combined and LVM was best predicted by including VO(2)max (r = 0.845, RMSE = 15.9 +/- 11.6 g). Conclusion LVM correlates poorly with QRS voltages with adipose tissue as a minor determinant in elite endurance athletes. LBM is the strongest single predictor of LVM but only marginally improves LVM prediction beyond ECG variables. In endurance athletes, LVM is best predicted by combining ECG, demographics and VO(2)max.
Keywords
Dual X-ray absorptiometry, Left ventricular mass, Electrocardiogram, Cardiac magnetic resonance imaging, Athlete

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MLA
De Bosscher, R., et al. “Relating QRS Voltages to Left Ventricular Mass and Body Composition in Elite Endurance Athletes.” EUROPEAN JOURNAL OF APPLIED PHYSIOLOGY, vol. 123, no. 3, 2023, pp. 547–59, doi:10.1007/s00421-022-05080-5.
APA
De Bosscher, R., Moeyersons, J., Dausin, C., Claeys, M., Janssens, K., Claus, P., … Pro@Heart, consortium. (2023). Relating QRS voltages to left ventricular mass and body composition in elite endurance athletes. EUROPEAN JOURNAL OF APPLIED PHYSIOLOGY, 123(3), 547–559. https://doi.org/10.1007/s00421-022-05080-5
Chicago author-date
De Bosscher, R, J Moeyersons, C Dausin, M Claeys, K Janssens, P Claus, K Goetschalckx, et al. 2023. “Relating QRS Voltages to Left Ventricular Mass and Body Composition in Elite Endurance Athletes.” EUROPEAN JOURNAL OF APPLIED PHYSIOLOGY 123 (3): 547–59. https://doi.org/10.1007/s00421-022-05080-5.
Chicago author-date (all authors)
De Bosscher, R, J Moeyersons, C Dausin, M Claeys, K Janssens, P Claus, K Goetschalckx, J Bogaert, CM Van De Heyning, B Paelinck, P Sanders, J Kalman, S Van Huffel, C Varon, A La Gerche, H Heidbuchel, G Claessen, R Willems, Kasper Favere, and consortium Pro@Heart. 2023. “Relating QRS Voltages to Left Ventricular Mass and Body Composition in Elite Endurance Athletes.” EUROPEAN JOURNAL OF APPLIED PHYSIOLOGY 123 (3): 547–559. doi:10.1007/s00421-022-05080-5.
Vancouver
1.
De Bosscher R, Moeyersons J, Dausin C, Claeys M, Janssens K, Claus P, et al. Relating QRS voltages to left ventricular mass and body composition in elite endurance athletes. EUROPEAN JOURNAL OF APPLIED PHYSIOLOGY. 2023;123(3):547–59.
IEEE
[1]
R. De Bosscher et al., “Relating QRS voltages to left ventricular mass and body composition in elite endurance athletes,” EUROPEAN JOURNAL OF APPLIED PHYSIOLOGY, vol. 123, no. 3, pp. 547–559, 2023.
@article{01GXRHZY1ZGFD383WCABN8HHF3,
  abstract     = {{Purpose Electrocardiogram (ECG) QRS voltages correlate poorly with left ventricular mass (LVM). Body composition explains some of the QRS voltage variability. The relation between QRS voltages, LVM and body composition in endurance athletes is unknown. Methods Elite endurance athletes from the Pro@Heart trial were evaluated with 12-lead ECG for Cornell and Sokolow-Lyon voltage and product. Cardiac magnetic resonance imaging assessed LVM. Dual energy x-ray absorptiometry assessed fat mass (FM) and lean mass of the trunk and whole body (LBM). The determinants of QRS voltages and LVM were identified by multivariable linear regression. Models combining ECG, demographics, DEXA and exercise capacity to predict LVM were developed. Results In 122 athletes (19 years, 71.3% male) LVM was a determinant of the Sokolow-Lyon voltage and product (beta = 0.334 and 0.477, p < 0.001) but not of the Cornell criteria. FM of the trunk (beta = - 0.186 and - 0.180, p < 0.05) negatively influenced the Cornell voltage and product but not the Sokolow-Lyon criteria. DEXA marginally improved the prediction of LVM by ECG (r = 0.773 vs 0.510, p < 0.001; RMSE = 18.9 +/- 13.8 vs 25.5 +/- 18.7 g, p > 0.05) with LBM as the strongest predictor (beta = 0.664, p < 0.001). DEXA did not improve the prediction of LVM by ECG and demographics combined and LVM was best predicted by including VO(2)max (r = 0.845, RMSE = 15.9 +/- 11.6 g). Conclusion LVM correlates poorly with QRS voltages with adipose tissue as a minor determinant in elite endurance athletes. LBM is the strongest single predictor of LVM but only marginally improves LVM prediction beyond ECG variables. In endurance athletes, LVM is best predicted by combining ECG, demographics and VO(2)max.}},
  author       = {{De Bosscher, R and Moeyersons, J and Dausin, C and Claeys, M and Janssens, K and Claus, P and Goetschalckx, K and Bogaert, J and Van De Heyning, CM and Paelinck, B and Sanders, P and Kalman, J and Van Huffel, S and Varon, C and La Gerche, A and Heidbuchel, H and Claessen, G and Willems, R and Favere, Kasper and Pro@Heart, consortium}},
  issn         = {{1439-6319}},
  journal      = {{EUROPEAN JOURNAL OF APPLIED PHYSIOLOGY}},
  keywords     = {{Dual X-ray absorptiometry,Left ventricular mass,Electrocardiogram,Cardiac magnetic resonance imaging,Athlete}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{547--559}},
  title        = {{Relating QRS voltages to left ventricular mass and body composition in elite endurance athletes}},
  url          = {{http://doi.org/10.1007/s00421-022-05080-5}},
  volume       = {{123}},
  year         = {{2023}},
}

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