To determine the associated factors of ECG abnormalities in athletes at Brazzaville (Republic of the Congo).

This cross-sectional study was conducted from April to August 2019 at the sport medical center of Alphonse Massamba-Débat stadium in Brazzaville. Included athletes were affiliated with national federations of disciplines recognized by the National Olympic Committee, aged from 12 to 35 years old, and have received a clinical examination and a resting ECG.

A total of 436 athletes were involved, including 334 males (76.6%). The mean age was 21.9±5.1 years (range 12 and 35 years). The sports concerned were: handball (n=137), football (n=94), taekwondo (n=57), basketball (n=54). The average weekly training duration was 8.6±2.6hours. The average duration of sports practice was 5.5±4.5 years. ECG showed abnormalities in 382 athletes (87.6%), including 56.2% physiological abnormalities, 7.8% borderline abnormalities and 23.6% pathological abnormalities. In the multivariate analysis, associated factors with the abnormalities were male sex (adjusted OR 4.4, 95%CI 2.3-8.6, p<0.001) and endurance sport, in particular: football (adjusted OR 2.4, 95%CI 1.2-11.7, P=0.03), marathon (adjusted OR 2.5, 95%CI 1.4-14.7, P=0.02) and volleyball (adjusted OR 4.2, 95%CI 1.7-3.3, P=0.04).

The study reports many ECG abnormalities among athletes in Brazzaville. These abnormalities should be explored by cardiac ultrasound and other methods of exploring heart, to identify athletes at risk of sudden death.