Evidence map›Paper›PMID 40475715›Full record

SynthesisReviews in cardiovascular medicine2025

ECG Screening in Athletes: A Systematic Review of Sport, Age, and Gender Variations.

Adela Caramoci, Alina Maria Smaranda, Teodora Simina Drăgoiu, Ioana Anca Bădărău

Abstract readSystematic Review
In one paragraph

Synthesis in Reviews in cardiovascular medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Adela CaramociDiscipline of Sports Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.ORCID https://orcid.org/0000-0003-3831-5916
Alina Maria SmarandaDiscipline of Sports Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.ORCID https://orcid.org/0000-0002-8610-2627
Teodora Simina DrăgoiuFaculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.ORCID https://orcid.org/0009-0002-6748-871X
Ioana Anca BădărăuDepartment of Physiology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.ORCID https://orcid.org/0000-0002-7282-5189

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The electrocardiogram (ECG) screening in athletes is essential due to the unique cardiac adaptations induced by intensive training. However, differentiating between physiological adaptations and pathological abnormalities remains a significant challenge, particularly when considering variations across different sports, ages, and genders. Methods: A systematic review of observational studies published between 2015 and 2025 was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data were extracted from 20 studies examining ECG changes in athletes across endurance, strength, and mixed sports, encompassing both adolescent and adult populations. Results: Commonly observed ECG changes included increased QRS amplitude, T-wave inversions, and sinus bradycardia, particularly in endurance athletes, while strength-based athletes frequently exhibited left ventricular hypertrophy. Male athletes showed higher QRS voltages, longer QRS durations, and higher PR intervals, whereas female athletes demonstrated elevated resting heart rates and prolonged corrected QT interval (QTc) intervals. Adolescents who engaged in regular sports displayed fewer abnormal ECG findings than adults; however, high-intensity training in adolescent athletes was associated with right atrial enlargement and increased P-wave duration. Detraining effectively reversed certain ECG changes, including prolonged QT intervals and T-wave abnormalities, though these changes often reappeared upon resumption of intense training. Notably, Conclusion: This review emphasizes the complexity of ECG interpretation in athletes, highlighting sport-specific, gender-based, and age-related variations. The persistent high false-positive rates underscore the need for refined, sport-specific ECG guidelines. Recent recognition of sports medicine as a primary specialty within the European Union (EU) reinforces the importance of comprehensive physician training. Integrating artificial intelligence (AI) technology into ECG screening can enhance diagnostic accuracy, reduce costs, and facilitate large-scale implementation. Meanwhile, collaborative efforts among clinicians, researchers, and policymakers are essential to developing cost-effective and standardized ECG screening protocols, ensuring improved athlete care, and advancing the field of sports cardiology.

Indexed as

athletesECG screeningelectrocardiographysports cardiology

Identifiers

PMID40475715
PMCPMC12135641

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.