International sporting organisations are increasingly using ECG-based screening to identify athletes at risk of sudden cardiac death (SCD).1 Since the introduction of athlete ECG interpretation criteria in 2005, numerous modifications have been made to improve their sensitivity and specificity.2 These include a nuanced classification of T-wave inversions (TWI), a potential feature of underlying cardiomyopathy. Since 2013, successive criteria have recommended that TWI confined to the anterior leads (V1–V4) and preceded by J-point elevation and convex ST-segment elevation in black athletes (BA) should be considered a physiological finding within the athlete’s heart spectrum—currently termed the ‘black athlete repolarisation variant’.2 This editorial examines the existing evidence and knowledge gaps in the clinical evaluation of anterior TWI in BA within Africa. The prevalence of anterior TWI among healthy athletes varies with age, sex, sporting discipline and race.2 Since the 1950s it has been recognised that anterior TWI is more common in black than white populations.3 With a prevalence of up to 27.3% among BA,4 the ‘black athlete repolarisation variant’ (figure 1) is considered a normal ECG manifestation of exercise-induced cardiac remodelling, although its significance outside this ethnic cohort remains unclear.5 While used here for brevity, the ‘black athlete repolarisation variant’ assumes that the non-black pattern is the norm, and this racialised presumption warrants reconsideration in future guidelines.5 6 Recommendations for athlete ECG interpretation have largely been derived from studies in Europe and North America. Research conducted within Africa has been sparse, with …

中文翻译：

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黑人运动员的前 T 波倒转：非洲视角

国际体育组织越来越多地使用基于心电图的筛查来识别有心源性猝死 (SCD) 风险的运动员。1 自 2005 年引入运动员心电图解读标准以来，已经进行了大量修改，以提高其敏感性和特异性。2 其中包括T 波倒置 (TWI) 的细致分类，这是潜在心肌病的一个潜在特征。自 2013 年以来，连续的标准建议，黑人运动员 (BA) 的 TWI 仅限于前导联 (V1–V4)，且之前有 J 点抬高和凸形 ST 段抬高，应将其视为运动员心率范围内的生理发现：目前被称为“黑人运动员复极变体”。2 这篇社论探讨了非洲 BA 前 TWI 临床评估中的现有证据和知识差距。健康运动员中前部 TWI 的患病率因年龄、性别、运动纪律和种族而异。2 自 20 世纪 50 年代以来，人们认识到前部 TWI 在黑人中比白人更常见。3 BA 中的患病率高达 27.3% ,4“黑人运动员复极变异”（图 1）被认为是运动引起的心脏重塑的正常心电图表现，尽管其在该种族群体之外的意义仍不清楚。5为简洁起见，此处使用“黑人运动员复极变异”假设非黑人模式是常态，这种种族化的推定值得在未来的指南中重新考虑。5 6 对运动员心电图解释的建议主要来自欧洲和北美的研究。在非洲进行的研究很少，......