*2.8. Data analysis and Statistics*

Data analysis was performed using SPSS 20.0 (Statistical Package for the Social Sciences, Chicago, IL, USA). Data were presented as mean ± standard deviation (SD), or as median with an interquartile range for continuous variables. These variables were compared by the non-parametric Mann–Whitney U test, considering that their distribution did not satisfy the assumption of normality, due to the small number of subjects included in the study. For the same reason, correlations between continuous variables were assessed by calculating the Spearman correlation coefficients. A two-sided *p*-value < 0.05 was considered significant for all analyses.

#### **3. Results**

#### *3.1. Anthropometric Data and Initial Clinical and Paraclinical Evaluation*

During the clinical evaluation, no significant pathological findings were encountered. The resting systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were within the normal range and no significant BP differences were noticed between the upper limbs or in the orthostatic position. Using the measured height and weight values, the body mass index (BMI) was calculated using the formula weight/(height)2. Most of them had a normal BMI (18.55–24.99 kg/m2), while four of them had a BMI of 25 kg/m<sup>2</sup> or above. Therefore, we measured the abdominal circumference and none of them had a value above 102 cm (see Table 4.).

**Table 4.** Anthropometric and baseline BP and HR values.


### *3.2. 12-Lead Resting ECG*

All subjects were in sinus rhythm and 14 had sinus bradycardia (HR < 60 bpm), while the other 5 had normal baseline HR. Two athletes had a right-heart axis deviation, and one had a 90-degree axis. Four of them had normal morphology, while in fourteen a high QRS-complex voltage was encountered, three showed a complete RBBB (RSR' pattern in the V1 and V2 leads and a QRS duration >0.12 s), and three displayed an incomplete RBBB (RSR' pattern only in the V1 lead and a QRS duration <0.12 s). By analyzing these patterns, the increased QRS complex voltage, the incomplete RBBB and the sinus bradycardia were considered to be normal for an athlete, while the complete RBBB and the right-axis deviation were considered borderline changes (see Table 1). However, they were not considered to be a reason to contraindicate further investigations.

### *3.3. Transthoracic Cardiac Ultrasound*

The TTE parameters were within the normal limits and no significant pathological encounters were made: two subjects had a mild tricuspid valve regurgitation, two had an anterior mitral valve prolapse, and two had a mild mitral valve regurgitation. However, these findings were considered benign and not a reason to contraindicate further investigations (see Table 5).
