TITLE:
The Heart of the Black African Female Athlete: Clinical, Electrocardiographic and Echocardiographic Features in a 54-Case Series
AUTHORS:
Ngoné Diaba Gaye, Joseph Salvador Mingou, Soumia Benaammouch, Malick Ndiaye, Marguerite Tening Diouf, Lamine Ly, Seydina Oumar Gueye, Mamadou Adama Thiam, Alassane Mbaye, Abdoul Kane, Aliou Alassane Ngaïdé
KEYWORDS:
Athlete’s Heart, Female Athlete, Electrocardiogram, Echocardiography, Black Africa
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.16 No.8,
August
26,
2026
ABSTRACT: Introduction: Regular sports practice induces cardiovascular adaptations known as athlete’s heart. These changes may involve the clinical examination, electrocardiogram and echocardiography, and may sometimes mimic structural or electrical heart disease. In Black African female athletes, reference data remain limited. This study aimed to analyse the clinical, electrocardiographic and echocardiographic features of the hearts of Black African female athletes competing in sports clubs in Senegal. Methods: This was a prospective, descriptive and analytical cross-sectional study conducted from 10 May to 30 June 2022 in three sports centres in Dakar. Black African female athletes aged at least 18 years, who had been practising competitive sport for more than one year and trained for at least five hours per week, were included. Anamnestic, clinical, electrocardiographic and echocardiographic data were collected using a standardised form. Resting 12-lead ECGs were interpreted according to international sports cardiology recommendations. Transthoracic echocardiography assessed chamber dimensions, wall thickness, left ventricular systolic function, TAPSE, diastolic parameters and pulmonary artery systolic pressure. Statistical analysis was performed using SPSS version 18, with statistical significance set at p Results: The study included 54 female athletes: 30 referees (55.6%), 16 volleyball players (29.6%) and 8 track-and-field athletes (14.8%). Mean age was 26.43 ± 6.06 years. Mean training volume was 6.65 ± 2.69 hours per week. The most frequent symptoms were palpitations (14.8%) and exertional dyspnoea (11.1%). On ECG, the main abnormalities were early repolarisation (35.2%), respiratory sinus arrhythmia (35.18%), sinus bradycardia (20.4%), precordial T-wave inversion (16.7%), atrial enlargement (16.66%) and incomplete right bundle branch block (13%). On echocardiography, left ventricular ejection fraction was preserved in all athletes. Left ventricular end-diastolic diameter was Conclusion: The athletes studied had an overall reassuring clinical and echocardiographic profile. Although several ECG findings were compatible with athlete’s heart, potentially pathological abnormalities were also observed, and their clinical significance could not be determined because follow-up was not systematically documented.