Right precordial T-wave inversion in healthy endurance athletes can be explained by lateral displacement of the cardiac apex

Abstract

Objectives The objective of this study was to test the hypothesis that T-wave inversion in the right precordial leads (TWIV2-3) reflects lateral displacement of the heart such that the surface electrocardiographic (ECG) leads overlie a greater proportion of the right ventricle (RV). Background TWIV2-3 on ECG is more frequently observed among endurance athletes (EAs) than in the general population, the underlying mechanism for which is unclear. Methods Sixty-eight EAs and 41 nonathletic control subjects underwent ECG and cardiac magnetic resonance imaging (CMRI). In addition to standard measurements of biventricular function and volume, novel measurements of cardiac displacement and orientati..