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June 12, 2026European Journal of Preventive CardiologyOpen Access

Prevalence and significance of anterior T-wave inversion in professional football players in the UK

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Key result

Black ethnicity in professional football players was associated with a significantly higher prevalence of anterior T-wave inversion compared to non-black players (11.3% vs 1.3%; p<0.001).

Why the study?

Does the prevalence and clinical significance of anterior T-wave inversion differ between black and non-black professional football players?

Population

11,595 professional football players undergoing preparticipation screening as part of the English Football…

Design

Cross-sectional

Authors

KYK YamagataHBH BaghertashSPS Picioreanu

Discussion

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Overview

ATWI is more prevalent yet rarely linked to major pathology in black football players; leaves open whether ethnicity-specific ECG criteria warrant prospective validation.

Key Points

  • This study aims to evaluate the prevalence and significance of anterior T-wave inversion in professional black and non-black football players.
  • Conducted an observational cross-sectional study with 11,595 football players from 2017-2024.
  • Players underwent preparticipation screening, including health questionnaires, 12-lead ECG, and transthoracic echocardiograms.
  • Categorized players into black and non-black based on ethnicity.
  • ATWI was observed in 341 (11.3%) black players vs. 115 (1.3%) non-black players (p<0.001).
  • No black player with ATWI had major cardiac pathology; one non-black player had arrhythmogenic cardiomyopathy (0.9%, p=0.31).
  • Among players with minor cardiac conditions, five black players had various issues compared to two non-black players.

Study Design

Type

Cross-Sectional (n=11,595)

Multicenter

Yes

Structured PICO

Does the prevalence and clinical significance of anterior T-wave inversion differ between black and non-black professional football players?

P
Population
11,595 professional football players (16.9% female) in the UK undergoing preparticipation cardiac screening between 2017 and 2024.
O
Outcome
Prevalence of anterior T-wave inversion (ATWI) and associated cardiac pathologysurrogate

Main Result

Absolute Event Rate: 11.3% vs 1.3%

p-value: p=<0.001

Anterior T-wave inversion is nearly nine times more frequent in black professional football players compared to non-black players, and its presence in non-black athletes warrants further investigation due to the risk of underlying cardiomyopathy.

Cite This Study

Yamagata et al. (2026) conducted a cross-sectional in Anterior T-wave inversion (n=11,595). Black ethnicity vs. Non-black ethnicity was evaluated on Prevalence of anterior T-wave inversion (ATWI) (p=<0.001). Black ethnicity in professional football players was associated with a significantly higher prevalence of anterior T-wave inversion compared to non-black players (11.3% vs 1.3%; p<0.001).

synapsesocial.com/papers/6a2bd1386550ea4541ffe9bahttps://doi.org/10.1093/eurjpc/zwag249.368
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Unravelling of the heart of the Afro-Caribbean athlete2026
  2. 2Electrocardiographic anterior T-wave inversion in athletes of different ethnicities: differential diagnosis between athlete's heart and cardiomyopathy2015 · 116 citations
  3. 3Prevalence and cardiac outcomes of T wave inversions in high school athletes: an analysis of 15 years of preparticipation screening ECGs2026
  4. 4Isolated Anterior T‐Wave Inversion in Elite Athletes: Prevalence and Clinical Relevance by Sex and Sporting Discipline2025
  5. 57-011 Electrocardiographic findings of elite British basketball players compared to elite British footballers using the international criteria for ECG interpretation in athletes2025