ОСОБЕННОСТИ ЭКГ СПОРТСМЕНОВ: ПРИВЫЧНЫЕ И ПОГРАНИЧНЫЕ ИЗМЕНЕНИЯ. ЧАСТЬ 2
Ключевые слова:
ЭКГ спортсмена, привычные изменения ЭКГ спортсмена, пограничные изменения ЭКГ спортсмена, спортивное сердце, адаптация к физическим нагрузкам
Аннотация
Цель: обобщение имеющихся литературных данных на тему привычных и пограничных изменений электрокардиограммы (ЭКГ) у спортсменов различного возраста и уровня подготовки. Материалы и методы. Данная статья представляет собой вторую часть работы, посвященной обзору публикаций российских и зарубежных авторов на указанную тему. В качестве примеров приводятся ЭКГ, зарегистрированные при углубленном медицинском обследовании спортсменов в Рязанском областном врачебно-физкультурном диспансере. Результаты. Электрокардиография остается одной из базовых методик, применяемых с целью контроля за состоянием здоровья спортсменов и решения вопроса о допуске к занятиям спортом и к соревновательной деятельности. Изменения на ЭКГ у атлетов широко распространены; в соответствии с международными критериями интерпретации ЭКГ их делят на привычные, пограничные и патологические. Привычные изменения ЭКГ связаны с регулярными физическими нагрузками и являются проявлением спортивного сердца. В статье описаны синдром ранней реполяризации желудочков, а также особенности реполяризации у темнокожих атлетов и спортсменов-подростков. Ряд исследований свидетельствует о том, что некоторые изменения ЭКГ, которые ранее считались патологическими, являются результатом физиологического ремоделирования сердца у спортсменов. Дополнительное обследование атлетов с такими изменениями, как правило, не выявляет патологии. Эти изменения считаются пограничными; к ним относятся отклонение электрической оси сердца влево и вправо, признаки дилатации левого и правого предсердий, полная блокада правой ножки пучка Гиса. Выявление одного пограничного изменения не требует дальнейшей оценки при отсутствии симптомов; при наличии двух и более изменений необходимо дополнительное обследование для исключения сердечно-сосудистых заболеваний, ассоциированных с внезапной сердечной смертью. Заключение. Знание привычных и пограничных изменений ЭКГ спортсменов, умение сопоставить их с данными спортивного анамнеза и результатами других методов исследования позволит минимизировать гипер- и гиподиагностику заболеваний сердца у спортсменов.
Литература
1. Бадтиева В.А., Шарыкин А.С., Павлов В.И., Пачина В.В. Ложноположительный диагноз инфаркта миокарда при синдроме ранней реполяризации желудочков у спортсмена // Кардиоваскулярная терапия и профилактика. 2017. Т. 16, № 2. C. 71–72. [Badtieva V.A., Sharykin A.S., Pavlov V.I. et al. [False Positive Diagnosis of Myocardial Infarction in Athletes with Early Ventricular Repolarization Syndrome]. Kardiovaskulyarnaya terapiya i profilaktika [Cardiovascular Therapy and Prevention], 2017, vol. 16, no. 2, pp. 71–72. (in Russ.)] DOI: 10.15829/1728-8800-2017-2-71-72
2. Мурашко В.В., Струтынский А.В. Электрокардиография. М.: МЕДпресс-информ, 2023. 360 с. [Murashko V.V., Strutynskiy A.V. Elektrokardiografiya: uchebnoe posobie [Electrocardiography]. Moscow, MEDpress-inform Publ., 2023. 360 p.]
3. Павлов В.И., Пачина А.В., Коледова Д.Н. и др. Привычные изменения ЭКГ спортсмена – современный подход // Медицинский алфавит. 2018. Т. 1, № 14 (351). С. 21–26. [Pavlov V.I., Pachina A.V., Koledova D.N. et al. [Habitual Changes in an Athlete's ECG – a Modern Approach]. Meditsinskiy alfavit [Medical Alphabet], 2018, vol. 1, no. 14 (351), pp. 21–26. (in Russ.)]
4. Orchard J.J., Orchard J.W., Davis A.J. et al. Clinical Outcomes of 10 Years of Cardiac Screening in Elite New Zealand Athletes. Journal of Science and Medicine in Sport, 2023, vol. 26, no. 12, pp. 659–666. DOI: 10.1016/j.jsams.2023.10.012
5. Claessen F.M.A.P., Peeters H.A.P., Sorgdrager B.J. et al. Early Repolarisation Among Athletes. BMJ Open Sport and Exercise Medicine, 2020, vol. 6, no. 1, e000694. DOI: 10.1136/bmjsem-2019-000694
6. Zimmermann P., Moser O., Edelmann F. et al. Electrical and Structural Adaption of Athlete's Heart and the Impact on Training and Recovery Management in Professional Basketball Players: A Retrospective Observational Study. Frontiers in Physiology, 2022, vol. 13, art. 739753. DOI: 10.3389/fphys.2022.739753
7. Yeo T.J., Wang M., Grignani R. et al. Electrocardiographic and Echocardiographic Insights From a Prospective Registry of Asian Elite Athletes. Frontiersin Cardiovascular Medicine, 2022, vol. 8, art. 799129. DOI: 10.3389/fcvm.2021.799129
8. Doumparatzi M., Sotiriou P., Deligiannis A., Kouidi E. Electrocardiographic Characteristics of Pediatric and Adolescent Football Players. Sports, Medicine and Health Scienses, 2023, vol. 6, no. 2, pp. 179–184. DOI: 10.1016/j.smhs.2023.12.004
9. Elenizi K. Prevalence and Clinical Significance of Early Repolarization in Athletes: A Systematic Review. Annals of Noninvasive Electrocardiology, 2025, vol. 30, no. 1, e70032. DOI: 10.1111/anec.70032
10. Kocsis L., Pap Z., László S.A. et al. Exercise-Induced Electrocardiographic Changes in Healthy Young Males with Early Repolarization Pattern. Diagnostics (Basel), 2024, vol. 14, no. 10, р. 980. DOI: 10.3390/diagnostics14100980
11. Hajduczok A.G., Ruge M., Emery M.S. Risk Factors for Sudden Death in Athletes, Is There a Role for Screening? Current Cardiovascular Risk Report, 2022, vol. 16, no. 10, pp. 97–109. DOI: 10.1007/s12170-022-00697-9
12. Drezner J.A., Sharma S., Baggish A., Papadakis M. International Criteria for Electrocardiographic Interpretation in Athletes: Consensus Statement. British Journal of Sports Medicine, 2017, vol. 51, no. 9, pp. 704–731. DOI: 10.1136/bjsports-2016-097331
13. Palermi S., Tardini L., Graziano F. et al. Interpretation and Management of T Wave Inversion in Athletes: An Expert Opinion Statement of the Italian Society of Sports Cardiology (SICSPORT). International Journal of Cardiology, 2025, vol. 422, 132968. DOI: 10.1016/j.ijcard.2025.132968
14. Pambo P., Scharhag J. Electrocardiographic and Echocardiographic Findings in Black Athletes: A General Review. Clinical Journal of Sport Medicine, 2021, vol. 31, no. 3, pp. 321–329. DOI: 10.1097/JSM.0000000000000754
15. Petek B.J., Drezner J.A., Churchill T.W. The International Criteria for Electrocardiogram Interpretation in Athletes: Common Pitfalls and Future Directions. Cardiac Electrophysiology Clinics, 2024, vol. 16, no. 1, pp. 35–49. DOI: 10.1016/j.ccep.2023.09.006
16. Papadakis M., Basavarajaiah S., Rawlins J. et al. Prevalence and Significance of T-wave Inversions in Predominantly Caucasian Adolescent Athletes. Europian Heart Journal, 2009, vol. 30, no. 14, pp. 1728–1735. DOI: 10.1093/eurheartj/ehp164
17. Gati S., Sheikh N., Ghani S. et al. Should Axis Deviation or Atrial Enlargement be Categorised as Abnormal in Young Athletes? The Athlete's Electrocardiogram: Time for Re-appraisal of Markers of Pathology. Europian Heart Journal, 2013, vol. 34, no. 47, pp. 3641–3648. DOI: 10.1093/eurheartj/eht390
18. Kim J.H., Noseworthy P.A., McCarty D. et al. Significance of Electrocardiographic Right Bundle Branch Block in Trained Athletes. The American Journal of Cardiology, 2011, vol. 107, no. 7, pp. 1083–1089. DOI: 10.1016/j.amjcard.2010.11.037
19. Singstad B.J. Norwegian Endurance Athlete ECG Database. IEEE Open Journal Engineering in Medicine and Biology, 2022, vol. 21, no. 3, pp. 162–166. DOI: 10.1109/OJEMB.2022.3214719
20. Stein R., Ferrari F., Silveira A.D.D. Electrocardiogram of Brazilian Elite Football Players: Filling a Gap. Arquivos Brasileiros de Cardiologia, 2023, vol. 120, no. 4, e20230090. DOI: 10.36660/abc.20230090
21. Anselmi F., Cangiano N., Fusi C. et al. The Determinants of Positivization of Anterior T-wave Inversion in Children. Journal of Sports Medicine and Physical Fitness, 2021, vol. 61, pp. 1548–1554. DOI: 10.23736/S0022-4707.20.11874-7
22. Davis A.J., Semsarian C., Orchard J.W. et al. The Impact of Ethnicity on Athlete ECG Interpretation: A Systematic Review. Journal of Cardiovascular Developement and Disease, 2022, vol. 9, no. 6, 183 p. DOI: 10.3390/jcdd9060183
23. Baba Ali N., Attaripour Esfahani S., Scalia I.G. et al. The Role of Cardiovascular Imaging in the Diagnosis of Athlete's Heart: Navigating the Shades of Grey. Journal of Imaging, 2024, vol. 10, no. 9, p. 230. DOI: 10.3390/jimaging10090230
24. Tremamunno S., Lanza G.A. Is Early Repolarization Syndrome a Risk for Sudden Cardiac Death in Young Athletes? Current Treatment Options in Cardiovascular Medicine, 2023, vol. 25, no. 10, pp. 561–571. DOI: 10.1007/s11936-023-01007-1
25. Yan G.X., Lankipalli R.S., Burke J.F. Ventricular Repolarization Components on the Electrocardiogram: Cellular Basis and Clinical Significance. Journal of the American College Cardiology, 2003, vol. 42, no. 3, pp. 401–409. DOI: 10.1016/s0735-1097(03)00713-7
2. Мурашко В.В., Струтынский А.В. Электрокардиография. М.: МЕДпресс-информ, 2023. 360 с. [Murashko V.V., Strutynskiy A.V. Elektrokardiografiya: uchebnoe posobie [Electrocardiography]. Moscow, MEDpress-inform Publ., 2023. 360 p.]
3. Павлов В.И., Пачина А.В., Коледова Д.Н. и др. Привычные изменения ЭКГ спортсмена – современный подход // Медицинский алфавит. 2018. Т. 1, № 14 (351). С. 21–26. [Pavlov V.I., Pachina A.V., Koledova D.N. et al. [Habitual Changes in an Athlete's ECG – a Modern Approach]. Meditsinskiy alfavit [Medical Alphabet], 2018, vol. 1, no. 14 (351), pp. 21–26. (in Russ.)]
4. Orchard J.J., Orchard J.W., Davis A.J. et al. Clinical Outcomes of 10 Years of Cardiac Screening in Elite New Zealand Athletes. Journal of Science and Medicine in Sport, 2023, vol. 26, no. 12, pp. 659–666. DOI: 10.1016/j.jsams.2023.10.012
5. Claessen F.M.A.P., Peeters H.A.P., Sorgdrager B.J. et al. Early Repolarisation Among Athletes. BMJ Open Sport and Exercise Medicine, 2020, vol. 6, no. 1, e000694. DOI: 10.1136/bmjsem-2019-000694
6. Zimmermann P., Moser O., Edelmann F. et al. Electrical and Structural Adaption of Athlete's Heart and the Impact on Training and Recovery Management in Professional Basketball Players: A Retrospective Observational Study. Frontiers in Physiology, 2022, vol. 13, art. 739753. DOI: 10.3389/fphys.2022.739753
7. Yeo T.J., Wang M., Grignani R. et al. Electrocardiographic and Echocardiographic Insights From a Prospective Registry of Asian Elite Athletes. Frontiersin Cardiovascular Medicine, 2022, vol. 8, art. 799129. DOI: 10.3389/fcvm.2021.799129
8. Doumparatzi M., Sotiriou P., Deligiannis A., Kouidi E. Electrocardiographic Characteristics of Pediatric and Adolescent Football Players. Sports, Medicine and Health Scienses, 2023, vol. 6, no. 2, pp. 179–184. DOI: 10.1016/j.smhs.2023.12.004
9. Elenizi K. Prevalence and Clinical Significance of Early Repolarization in Athletes: A Systematic Review. Annals of Noninvasive Electrocardiology, 2025, vol. 30, no. 1, e70032. DOI: 10.1111/anec.70032
10. Kocsis L., Pap Z., László S.A. et al. Exercise-Induced Electrocardiographic Changes in Healthy Young Males with Early Repolarization Pattern. Diagnostics (Basel), 2024, vol. 14, no. 10, р. 980. DOI: 10.3390/diagnostics14100980
11. Hajduczok A.G., Ruge M., Emery M.S. Risk Factors for Sudden Death in Athletes, Is There a Role for Screening? Current Cardiovascular Risk Report, 2022, vol. 16, no. 10, pp. 97–109. DOI: 10.1007/s12170-022-00697-9
12. Drezner J.A., Sharma S., Baggish A., Papadakis M. International Criteria for Electrocardiographic Interpretation in Athletes: Consensus Statement. British Journal of Sports Medicine, 2017, vol. 51, no. 9, pp. 704–731. DOI: 10.1136/bjsports-2016-097331
13. Palermi S., Tardini L., Graziano F. et al. Interpretation and Management of T Wave Inversion in Athletes: An Expert Opinion Statement of the Italian Society of Sports Cardiology (SICSPORT). International Journal of Cardiology, 2025, vol. 422, 132968. DOI: 10.1016/j.ijcard.2025.132968
14. Pambo P., Scharhag J. Electrocardiographic and Echocardiographic Findings in Black Athletes: A General Review. Clinical Journal of Sport Medicine, 2021, vol. 31, no. 3, pp. 321–329. DOI: 10.1097/JSM.0000000000000754
15. Petek B.J., Drezner J.A., Churchill T.W. The International Criteria for Electrocardiogram Interpretation in Athletes: Common Pitfalls and Future Directions. Cardiac Electrophysiology Clinics, 2024, vol. 16, no. 1, pp. 35–49. DOI: 10.1016/j.ccep.2023.09.006
16. Papadakis M., Basavarajaiah S., Rawlins J. et al. Prevalence and Significance of T-wave Inversions in Predominantly Caucasian Adolescent Athletes. Europian Heart Journal, 2009, vol. 30, no. 14, pp. 1728–1735. DOI: 10.1093/eurheartj/ehp164
17. Gati S., Sheikh N., Ghani S. et al. Should Axis Deviation or Atrial Enlargement be Categorised as Abnormal in Young Athletes? The Athlete's Electrocardiogram: Time for Re-appraisal of Markers of Pathology. Europian Heart Journal, 2013, vol. 34, no. 47, pp. 3641–3648. DOI: 10.1093/eurheartj/eht390
18. Kim J.H., Noseworthy P.A., McCarty D. et al. Significance of Electrocardiographic Right Bundle Branch Block in Trained Athletes. The American Journal of Cardiology, 2011, vol. 107, no. 7, pp. 1083–1089. DOI: 10.1016/j.amjcard.2010.11.037
19. Singstad B.J. Norwegian Endurance Athlete ECG Database. IEEE Open Journal Engineering in Medicine and Biology, 2022, vol. 21, no. 3, pp. 162–166. DOI: 10.1109/OJEMB.2022.3214719
20. Stein R., Ferrari F., Silveira A.D.D. Electrocardiogram of Brazilian Elite Football Players: Filling a Gap. Arquivos Brasileiros de Cardiologia, 2023, vol. 120, no. 4, e20230090. DOI: 10.36660/abc.20230090
21. Anselmi F., Cangiano N., Fusi C. et al. The Determinants of Positivization of Anterior T-wave Inversion in Children. Journal of Sports Medicine and Physical Fitness, 2021, vol. 61, pp. 1548–1554. DOI: 10.23736/S0022-4707.20.11874-7
22. Davis A.J., Semsarian C., Orchard J.W. et al. The Impact of Ethnicity on Athlete ECG Interpretation: A Systematic Review. Journal of Cardiovascular Developement and Disease, 2022, vol. 9, no. 6, 183 p. DOI: 10.3390/jcdd9060183
23. Baba Ali N., Attaripour Esfahani S., Scalia I.G. et al. The Role of Cardiovascular Imaging in the Diagnosis of Athlete's Heart: Navigating the Shades of Grey. Journal of Imaging, 2024, vol. 10, no. 9, p. 230. DOI: 10.3390/jimaging10090230
24. Tremamunno S., Lanza G.A. Is Early Repolarization Syndrome a Risk for Sudden Cardiac Death in Young Athletes? Current Treatment Options in Cardiovascular Medicine, 2023, vol. 25, no. 10, pp. 561–571. DOI: 10.1007/s11936-023-01007-1
25. Yan G.X., Lankipalli R.S., Burke J.F. Ventricular Repolarization Components on the Electrocardiogram: Cellular Basis and Clinical Significance. Journal of the American College Cardiology, 2003, vol. 42, no. 3, pp. 401–409. DOI: 10.1016/s0735-1097(03)00713-7
2. Мурашко В.В., Струтынский А.В. Электрокардиография. М.: МЕДпресс-информ, 2023. 360 с. [Murashko V.V., Strutynskiy A.V. Elektrokardiografiya: uchebnoe posobie [Electrocardiography]. Moscow, MEDpress-inform Publ., 2023. 360 p.]
3. Павлов В.И., Пачина А.В., Коледова Д.Н. и др. Привычные изменения ЭКГ спортсмена – современный подход // Медицинский алфавит. 2018. Т. 1, № 14 (351). С. 21–26. [Pavlov V.I., Pachina A.V., Koledova D.N. et al. [Habitual Changes in an Athlete's ECG – a Modern Approach]. Meditsinskiy alfavit [Medical Alphabet], 2018, vol. 1, no. 14 (351), pp. 21–26. (in Russ.)]
4. Orchard J.J., Orchard J.W., Davis A.J. et al. Clinical Outcomes of 10 Years of Cardiac Screening in Elite New Zealand Athletes. Journal of Science and Medicine in Sport, 2023, vol. 26, no. 12, pp. 659–666. DOI: 10.1016/j.jsams.2023.10.012
5. Claessen F.M.A.P., Peeters H.A.P., Sorgdrager B.J. et al. Early Repolarisation Among Athletes. BMJ Open Sport and Exercise Medicine, 2020, vol. 6, no. 1, e000694. DOI: 10.1136/bmjsem-2019-000694
6. Zimmermann P., Moser O., Edelmann F. et al. Electrical and Structural Adaption of Athlete's Heart and the Impact on Training and Recovery Management in Professional Basketball Players: A Retrospective Observational Study. Frontiers in Physiology, 2022, vol. 13, art. 739753. DOI: 10.3389/fphys.2022.739753
7. Yeo T.J., Wang M., Grignani R. et al. Electrocardiographic and Echocardiographic Insights From a Prospective Registry of Asian Elite Athletes. Frontiersin Cardiovascular Medicine, 2022, vol. 8, art. 799129. DOI: 10.3389/fcvm.2021.799129
8. Doumparatzi M., Sotiriou P., Deligiannis A., Kouidi E. Electrocardiographic Characteristics of Pediatric and Adolescent Football Players. Sports, Medicine and Health Scienses, 2023, vol. 6, no. 2, pp. 179–184. DOI: 10.1016/j.smhs.2023.12.004
9. Elenizi K. Prevalence and Clinical Significance of Early Repolarization in Athletes: A Systematic Review. Annals of Noninvasive Electrocardiology, 2025, vol. 30, no. 1, e70032. DOI: 10.1111/anec.70032
10. Kocsis L., Pap Z., László S.A. et al. Exercise-Induced Electrocardiographic Changes in Healthy Young Males with Early Repolarization Pattern. Diagnostics (Basel), 2024, vol. 14, no. 10, р. 980. DOI: 10.3390/diagnostics14100980
11. Hajduczok A.G., Ruge M., Emery M.S. Risk Factors for Sudden Death in Athletes, Is There a Role for Screening? Current Cardiovascular Risk Report, 2022, vol. 16, no. 10, pp. 97–109. DOI: 10.1007/s12170-022-00697-9
12. Drezner J.A., Sharma S., Baggish A., Papadakis M. International Criteria for Electrocardiographic Interpretation in Athletes: Consensus Statement. British Journal of Sports Medicine, 2017, vol. 51, no. 9, pp. 704–731. DOI: 10.1136/bjsports-2016-097331
13. Palermi S., Tardini L., Graziano F. et al. Interpretation and Management of T Wave Inversion in Athletes: An Expert Opinion Statement of the Italian Society of Sports Cardiology (SICSPORT). International Journal of Cardiology, 2025, vol. 422, 132968. DOI: 10.1016/j.ijcard.2025.132968
14. Pambo P., Scharhag J. Electrocardiographic and Echocardiographic Findings in Black Athletes: A General Review. Clinical Journal of Sport Medicine, 2021, vol. 31, no. 3, pp. 321–329. DOI: 10.1097/JSM.0000000000000754
15. Petek B.J., Drezner J.A., Churchill T.W. The International Criteria for Electrocardiogram Interpretation in Athletes: Common Pitfalls and Future Directions. Cardiac Electrophysiology Clinics, 2024, vol. 16, no. 1, pp. 35–49. DOI: 10.1016/j.ccep.2023.09.006
16. Papadakis M., Basavarajaiah S., Rawlins J. et al. Prevalence and Significance of T-wave Inversions in Predominantly Caucasian Adolescent Athletes. Europian Heart Journal, 2009, vol. 30, no. 14, pp. 1728–1735. DOI: 10.1093/eurheartj/ehp164
17. Gati S., Sheikh N., Ghani S. et al. Should Axis Deviation or Atrial Enlargement be Categorised as Abnormal in Young Athletes? The Athlete's Electrocardiogram: Time for Re-appraisal of Markers of Pathology. Europian Heart Journal, 2013, vol. 34, no. 47, pp. 3641–3648. DOI: 10.1093/eurheartj/eht390
18. Kim J.H., Noseworthy P.A., McCarty D. et al. Significance of Electrocardiographic Right Bundle Branch Block in Trained Athletes. The American Journal of Cardiology, 2011, vol. 107, no. 7, pp. 1083–1089. DOI: 10.1016/j.amjcard.2010.11.037
19. Singstad B.J. Norwegian Endurance Athlete ECG Database. IEEE Open Journal Engineering in Medicine and Biology, 2022, vol. 21, no. 3, pp. 162–166. DOI: 10.1109/OJEMB.2022.3214719
20. Stein R., Ferrari F., Silveira A.D.D. Electrocardiogram of Brazilian Elite Football Players: Filling a Gap. Arquivos Brasileiros de Cardiologia, 2023, vol. 120, no. 4, e20230090. DOI: 10.36660/abc.20230090
21. Anselmi F., Cangiano N., Fusi C. et al. The Determinants of Positivization of Anterior T-wave Inversion in Children. Journal of Sports Medicine and Physical Fitness, 2021, vol. 61, pp. 1548–1554. DOI: 10.23736/S0022-4707.20.11874-7
22. Davis A.J., Semsarian C., Orchard J.W. et al. The Impact of Ethnicity on Athlete ECG Interpretation: A Systematic Review. Journal of Cardiovascular Developement and Disease, 2022, vol. 9, no. 6, 183 p. DOI: 10.3390/jcdd9060183
23. Baba Ali N., Attaripour Esfahani S., Scalia I.G. et al. The Role of Cardiovascular Imaging in the Diagnosis of Athlete's Heart: Navigating the Shades of Grey. Journal of Imaging, 2024, vol. 10, no. 9, p. 230. DOI: 10.3390/jimaging10090230
24. Tremamunno S., Lanza G.A. Is Early Repolarization Syndrome a Risk for Sudden Cardiac Death in Young Athletes? Current Treatment Options in Cardiovascular Medicine, 2023, vol. 25, no. 10, pp. 561–571. DOI: 10.1007/s11936-023-01007-1
25. Yan G.X., Lankipalli R.S., Burke J.F. Ventricular Repolarization Components on the Electrocardiogram: Cellular Basis and Clinical Significance. Journal of the American College Cardiology, 2003, vol. 42, no. 3, pp. 401–409. DOI: 10.1016/s0735-1097(03)00713-7
References
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Опубликован
2026-10-04
Как цитировать
Мирошкина, Т., Трутнева, Е., Лапкин, М., & Артёмова, Н. (2026). ОСОБЕННОСТИ ЭКГ СПОРТСМЕНОВ: ПРИВЫЧНЫЕ И ПОГРАНИЧНЫЕ ИЗМЕНЕНИЯ. ЧАСТЬ 2. Человек. Спорт. Медицина, 26(2), 77-84. https://doi.org/10.14529/hsm260208
Выпуск
Раздел
Физиология
