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Serum Electrolyte Relationship to Electrocardiographic Change in Exercising Athletes FREE

Kenneth D. Rose, MD; F. Lowell Dunn, MD
[+] Author Affiliations

Read before the 43rd annual meeting of the American College Health Association, Miami Beach, Fla, April 30, 1965.

Reprint requests to University Health Service, University of Nebraska, Lincoln 68509 (Dr. Rose).


Dennis Bargen

From the Division of Research, University of Nebraska Health Service, Lincoln (Dr. Rose and Mr. Bargen), and the Biophysical Division, Eppley Foundation for Research, Omaha (Dr. Dunn).


JAMA. 1966;195(2):111-114. doi:10.1001/jama.1966.03100020099024
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Increase in amplitude and peaking of the T wave of the electrocardiogram following exercise is a well-known phenomenon. It was first reported in 1908 by Muller and Nicholai,1 and their observations have been frequently confirmed in the following years.2,3 The peaked precordial T wave associated with the immediate postexercise period is essentially identical with T wave in hyperkalemia. However, very little effort has been made to correlate the two, although there have been numerous well-documented reports linking physical exercise to transient increases in serum and plasma potassium levels.4 Since Fenn's5,6 excellent review articles, it has been an accepted fact that potassium efflux from somatic muscle to extracellular space attends contraction, and Grupp,7 among others, has shown that potassium transfer from the extracellular spaces surrounding muscle cells in situ to the circulating plasma is extremely rapid, if not instantaneous.

Winkler, et al8 in slow-perfusion experiments

REFERENCES

Muller and Nicholai:  Effect of Exercise on T-Waves , Zentralbl Physiologie 22:58, 1908;.
Katz, L.N.:  The Significance of the T-Wave in the Electrogram and Electrocardiogram , Physiol Rev 8:447-500 ( (Oct) ) 1928;.
Hartwell, A.A., et al.  Effect of Exercise and of Four Commonly Used Drugs on Normal Human Electrocardiograms With Particular Reference to T-Wave Changes , J Clin Invest 21:409-417 ( (July) ) 1942;.
Kahn, K.A., and Simonson, E.:  Changes in Mean Spatial QRS and T-Vectors and of Conventional Electrocardiographic Items in Hard Anaerobic Work , Circ Res 5:629-633 ( (Nov) ) 1957;.
DeLanne, R.; Barnes, J.R.; and Brouha, L.:  Changes in Osmotic Pressure and Ionic Concentrations of Plasma During Muscular Work and Recovery , J Appl Physiol 14:804-808 ( (May) ) 1959;.
Fenn. W.O.:  Electrolytes in Muscle , Physiol Rev 16:450-487 ( (July) ) 1936;.
Fenn, W.O.:  The Role of Potassium in Physiological Processes , Physiol Rev 20:377-415 ( (July) ) 1940;.
Grupp, G.:  Potassium Exchange in the Dog Heart in Situ , Circ Res 13:279-289 ( (Oct) ) 1963;.
Winkler, A.W.: Hoff, H.E.; and Smith, P.K.:  Electrocardiographic Changes and Concentration of Potassium in Serum Following Intravenous Injection of Potassium Chloride , Amer J Physiol 124:478-483 ( (Nov) ) 1938;.
Braun, H.A.; Surawicz, B.; and Bellet, S.:  T-Waves in Hyperpotassemia: Their Differentiation From Simulating T-Waves in Other Conditions , Amer J Med Sci 230:147-156 ( (Aug) ) 1955;.
Beckner, G.S., and Winsor, T.:  Cardiovascular Adaptation to Prolonged Physical Effort , Circulation 9:835-846 ( (June) ) 1954;.
Cureton, T.K., Jr.:  Effects of Longitudinal Physical Training on the Amplitude of the Highest Precordial T-Wave of the ECG , Med Sportiva 12:259-281 ( (July) ) 1958;.
Rose, K.D.: " Telemetering Physiologic Data From Athletes ," in Proceedings 1965 International Telemetering Conference , Pasadena, Calif: F. G. McGavock Associates, 1965;, pp 225-241.
Rose, K.D., and Dunn, F.L.: " A Study of Heart Function in Athletes by Telemetered Electrocardiography ," in Proceedings of the Fifth Annual Conference on Medical Aspects of Sports , Chicago: American Medical Assoc., 1963;, pp 30-37.
Ferro, P.V., and Hamm, A.B.:  A Simple Spectrophotometric Method for the Determination of Calcium , Amer J Clin Path 28: 208-217 ( (Aug) ) 1957;.
Wit, A.G.; Dalderup, L.M.; and Pol, G.:  Muscular Work and Potassium Supply , Acta Physiol Pharmacol Neerl 11:405-410 ( (March) ) 1962;.
Keith, N.H.; Osterberg, A.E.; and Burchell, H.B.:  Some Effects of Potassium Salts in Man , Ann Intern Med 16:879-892 ( (May) ) 1942;.
Lade, R., and Brown. E.B., Jr.:  Movement of Potassium Between Muscle and Blood in Response to Respiratory Acidosis , Amer J Physiol 204:761-764 ( (May) ) 1963;.
Brown, E.B., and Goot, B.:  Intracellular Hydrogen Ion Changes and Potassium Movement , Amer J Physiol 204:765-770 ( (May) ) 1963;.
Rose, K.D., and Dunn, F.L.:  The Heart of the Spectator Sportsman , Med Times 92:945-951 ( (Oct) ) 1964;.
Roman, J.A.:  Cardiorespiratory Functioning in Flight , Aerospace Med 34:322-337 ( (April) ) 1963;.

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Muller and Nicholai:  Effect of Exercise on T-Waves , Zentralbl Physiologie 22:58, 1908;.
Katz, L.N.:  The Significance of the T-Wave in the Electrogram and Electrocardiogram , Physiol Rev 8:447-500 ( (Oct) ) 1928;.
Hartwell, A.A., et al.  Effect of Exercise and of Four Commonly Used Drugs on Normal Human Electrocardiograms With Particular Reference to T-Wave Changes , J Clin Invest 21:409-417 ( (July) ) 1942;.
Kahn, K.A., and Simonson, E.:  Changes in Mean Spatial QRS and T-Vectors and of Conventional Electrocardiographic Items in Hard Anaerobic Work , Circ Res 5:629-633 ( (Nov) ) 1957;.
DeLanne, R.; Barnes, J.R.; and Brouha, L.:  Changes in Osmotic Pressure and Ionic Concentrations of Plasma During Muscular Work and Recovery , J Appl Physiol 14:804-808 ( (May) ) 1959;.
Fenn. W.O.:  Electrolytes in Muscle , Physiol Rev 16:450-487 ( (July) ) 1936;.
Fenn, W.O.:  The Role of Potassium in Physiological Processes , Physiol Rev 20:377-415 ( (July) ) 1940;.
Grupp, G.:  Potassium Exchange in the Dog Heart in Situ , Circ Res 13:279-289 ( (Oct) ) 1963;.
Winkler, A.W.: Hoff, H.E.; and Smith, P.K.:  Electrocardiographic Changes and Concentration of Potassium in Serum Following Intravenous Injection of Potassium Chloride , Amer J Physiol 124:478-483 ( (Nov) ) 1938;.
Braun, H.A.; Surawicz, B.; and Bellet, S.:  T-Waves in Hyperpotassemia: Their Differentiation From Simulating T-Waves in Other Conditions , Amer J Med Sci 230:147-156 ( (Aug) ) 1955;.
Beckner, G.S., and Winsor, T.:  Cardiovascular Adaptation to Prolonged Physical Effort , Circulation 9:835-846 ( (June) ) 1954;.
Cureton, T.K., Jr.:  Effects of Longitudinal Physical Training on the Amplitude of the Highest Precordial T-Wave of the ECG , Med Sportiva 12:259-281 ( (July) ) 1958;.
Rose, K.D.: " Telemetering Physiologic Data From Athletes ," in Proceedings 1965 International Telemetering Conference , Pasadena, Calif: F. G. McGavock Associates, 1965;, pp 225-241.
Rose, K.D., and Dunn, F.L.: " A Study of Heart Function in Athletes by Telemetered Electrocardiography ," in Proceedings of the Fifth Annual Conference on Medical Aspects of Sports , Chicago: American Medical Assoc., 1963;, pp 30-37.
Ferro, P.V., and Hamm, A.B.:  A Simple Spectrophotometric Method for the Determination of Calcium , Amer J Clin Path 28: 208-217 ( (Aug) ) 1957;.
Wit, A.G.; Dalderup, L.M.; and Pol, G.:  Muscular Work and Potassium Supply , Acta Physiol Pharmacol Neerl 11:405-410 ( (March) ) 1962;.
Keith, N.H.; Osterberg, A.E.; and Burchell, H.B.:  Some Effects of Potassium Salts in Man , Ann Intern Med 16:879-892 ( (May) ) 1942;.
Lade, R., and Brown. E.B., Jr.:  Movement of Potassium Between Muscle and Blood in Response to Respiratory Acidosis , Amer J Physiol 204:761-764 ( (May) ) 1963;.
Brown, E.B., and Goot, B.:  Intracellular Hydrogen Ion Changes and Potassium Movement , Amer J Physiol 204:765-770 ( (May) ) 1963;.
Rose, K.D., and Dunn, F.L.:  The Heart of the Spectator Sportsman , Med Times 92:945-951 ( (Oct) ) 1964;.
Roman, J.A.:  Cardiorespiratory Functioning in Flight , Aerospace Med 34:322-337 ( (April) ) 1963;.
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