Abstract
BACKGROUND: Cardiac adaptations in athletes, particularly football players, often result in distinct electrocardiographic (ECG) and echocardiographic changes. This study evaluates these cardiac patterns in Nigerian national football players compared to matched non-athlete controls. METHODOLOGY: A case-control study was conducted from January 2022 to December 2023 during pre-participation screenings of national football teams: Super Eagles, Flying Eagles, Golden Eaglets, Super Falcons, and Falconets. Seventy-eight athletes (aged 18-32) were compared with 42 age- and sex-matched controls drawn from team officials and supporters. Inclusion criteria required active participation in professional football for athletes and absence of known cardiac disease for controls. All participants underwent detailed history, physical examination, resting ECG, and 2D echocardiography. ECGs were assessed for features suggestive of athlete's heart or hypertrophic cardiomyopathy. Echocardiograms were performed with a Hewlett-Packard Sonos 2500 using a 3.5 MHz probe to measure ventricular dimensions, wall thickness, and function. RESULTS: Footballers demonstrated significant cardiac adaptations. ECGs showed lower mean heart rates, longer PR intervals, and a higher prevalence of sinus bradycardia and incomplete right bundle branch block. Additionally, footballers had higher R/S wave voltages and more frequent ST-segment elevations. Echocardiographic findings revealed larger left ventricular end-diastolic and end-systolic dimensions, as well as increased interventricular septal and posterior wall thickness, consistent with physiological, not pathological, hypertrophy. CONCLUSION: Nigerian national football players exhibit characteristic ECG and echocardiographic patterns reflecting physiological cardiac remodeling due to intensive training. Differentiating these benign adaptations from pathological findings is essential for accurate cardiovascular assessment and safe sports participation.