Prevalence Of Early Repolarization Research Articles

Ethnic differences in normal electrocardiographic findings in elite brazilian football players: b-pro foot ECG pilot study

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): CNPq, CAPES, FIPE-HCPA. Introduction The 12-lead electrocardiogram (ECG-12) is a useful tool in the assessment of athletes. The prevalence of normal electrocardiographic findings in elite Brazilian football players (EBFP) of different ethnicities is not well described. Purpose To compare the prevalence of normal ECG-12 findings in Caucasian, Mixed-race (MR), and Afro-Brazilian (AB) EBFP. Methods A multicenter cross-sectional descriptive study was conducted with exams performed on EBFP as a pre-participation assessment from February 18, 2002, through October 20, 2022. Results 4,363 EBFP from 51 professional clubs (from all five regions of Brazil; 15 states, and 21 cities), aged 15-35 years (median: 19 years; IQR: 16-23) were evaluated. 2,027 were Caucasians, 1,324 were MRs, and 1,012 were ABs. In general, we recorded 4,155 ECG-12 with normal variations (95.2%). Positive Sokolow-Lyon criteria for left ventricular hypertrophy was more prevalent in ABs (41.8%) than in Caucasians (33.4%), or MRs (32.7%). The prevalence of early repolarization in ABs (41.5%) was higher than in Caucasians (34.6%), or MRs (35.5%). The PR interval was longer in ABs (157.1 ms) than in Caucasians (151.4 ms), or MRs (153.3 ms), and the first-degree atrioventricular block was more frequent in ABs compared to MRs (4.2% vs. 2.3%, respectively). On the other hand, Caucasians had a higher prevalence of incomplete right bundle branch block (14.2%) than MRs (11.2%), or ABs (9.7%). In our sample, only three EBFP showed second-degree atrioventricular block Mobitz type I (0.07%; one Caucasian and two AB athletes). Conclusions This is the first large study to compare the prevalence of ECG-12 findings in EBFP from different ethnic groups. Those of AB origin have a significantly higher prevalence of ECG-12 findings compatible with the athlete's heart than Caucasians and MRs.

Early repolarization is independently associated with African-American race, younger age, higherBMI and lower heart rate.

Background: Early repolarization (ER) is commonly seen in young adults. The goal of this study was to evaluate predictors of ER. Method: The authors used ECGs, available from 636 subjects, performed on healthy students for screening purposes. Results: The prevalence of ER was 13.5%. The prevalence of ER was higher in African-American subjects (48.0% vs 10.8%; odds ratio: 5.9; CI: 3.5-9.7; p<0.0001), those with a BMI >25 (18.6% vs 11.7%; p=0.02), those age <30 (16.4% vs 2.0%; p<0.0001), male subjects (17.1% vs 8.3%; p=0.001) and those with heart rate <70 (18.2% vs 9.2%; p=0.001). With multivariate analysis, except gender, all other parameters remained significantly correlating with ER. Conclusion: The authors found younger age, African-American race, higher BMI and lower heart rate to be predictors of ER.

The electrocardiographic peculiarities of Algerian competitive athletes in the region of Sétif

to study electrocardiographic abnormalities in Algerian competitive athletes in the Sétif region, and compare with other international studies. 621 competitive athletes aged 12 and over (86% male, mean age 17.38 years) were included in our observational and cross-sectional epidemiological study. Our study confirms the rarity of rhythmic incidents in athletes (regular sinus rhythm 81.3%, sinus arrhythmia 17.7%, rhythm disorders 1%). The prevalence of bradycardia is 20.6%. It is proportional to age and more pronounced among male athletes, the influence of training on heart rate is not significant since 8 hours of training per week. The prevalence of fragmented QRS is 12.6%. The index of Sokolow-Lyon > 35 mm is found in 31.9% of athletes, with a male predominance. The pathology index is found in 8.2% of athletes without significant difference between the two sexes, these criteria of the HVG are not influenced by training, but rather by the type of sport activity and the intensity of dynamic activity. The prevalence of BAV 1 (1.3% in our study) is independent of the importance of bradycardia. The prevalence of early repolarization (RP) is 26.1%, with male predominance. We investigated the influence of age, gender, sport, training, electrical LVH and heart rate on RP. The lower topography of RP is the most common (65.4%) and hooking is the predominant aspect (57.4%). The latter is influenced by gender, age, type of sport, training, heart rate and QRS range. While the impasto is influenced only by the amplitude of the QRS. PR is associated with concave and ascending ST segment elevation in 30.7% of cases. The prevalence of non-specific branch blocks is 1.3% ( Table 1 ). The ECG was normal in 29.3% of athletes with a female predominance and presents adaptive abnormalities to regular exercise in 66.3% with male predominance. 4.3% of athletes (with a female predominance) have abnormal aspects, not related to sports training.

P6584Prevalence of early repolarization in Thailand and long term risk of cardiac mortality

Abstract Introduction Early repolarization syndrome is associated with long-term cardiac mortality in Western countries. However, there is no study of this association in Southeast Asian population. Purpose To determine the prevalence of early repolarization and long term risk of cardiac mortality in general Thai population. Methods A total of 2,756 consecutive individuals participating in from the electricity generating authority of Thailand (EGAT) study between 1997 and 2015 were included in this study. Early repolarization pattern (ERP) was defined either as “notching” or “slurring” and was localized into inferior leads, lateral leads, or both. Mortality endpoints included cardiovascular (CV) events and all-cause mortalities. Multivariable Cox-proportional hazard model, adjusted for all major CV risk factors, was used to determine the association between ERP and outcomes. Results Out of 2756 individuals,2,689 had complete data (80% male, mean age 55). ECGs and risk factor profiles were included for analysis. Mean follow up duration was 11.2±6.7 years. There were 444 (16.5%) cases with early repolarization pattern (slurr 54.3%, notching 38.3% and both 7.4%). Inferior leads were the most common localization at 49.8%, followed by lateral leads (35.6%) and both (14.6%). Five-hundred and sixty-six participants were dead during the follow-ups. Of these, 21 were sudden death. ERP was not associated with a greater likelihood of all causes of deaths, 20.5% in ERP and 21.2% in non-ERP (hazard ratio,1.04; 95% confidence interval (CI), 0.81 to 1.34; p=0.75). The death rates from coronary heart disease were 7.2% in ERP and 7.6% in non-ERP (HR,1.06; 95% CI, 0.71 to 1.56; p=0.79). The death rates from cardiovascular disease were 11.7% in ERP and 12.0% respectively (HR,1.03; 95% CI, 0.75 to 1.41; p=0.872) and sudden cardiac death was not difference between both groups 1.2 and 1.4% respectively. Conclusion The prevalence of early repolarization in Thai middle-aged population is relatively high. Over a long-term follow-up of 18 years, we did not find any differences in sudden cardiac death or death from any causes between an early repolarizationgroup and non-early repolarization group.

Left ventricular geometry and function in early repolarization: results from the population-based Gutenberg Health Study

The electrocardiographic pattern of early repolarization (ER) is related to increased cardiac mortality in the general population. The pathophysiological basis of ER is largely unknown. We investigated the association of echocardiographic structural and functional parameters of the left ventricle with the presence of ER in the community. The presence of ER (ER+) was assessed in 13,878 participants (mean age 54.6 years, 51.1% women) of the Gutenberg Health Study and related to left ventricular structure and function derived from standard echocardiography. The prevalence of ER was 5.0% (694/13,878), with higher prevalence in men than women (6.6% vs. 3.5%, p < 0.001). In men baseline characteristics differed including a lower BMI and a lower heart rate in ER+ individuals, whereas in women there were only minor differences. Multivariable-adjusted logistic regression analysis in men showed an association of ER with smaller diameters (left-ventricular end-diastolic diameter: OR 0.77 95% CI 0.69-0.86, p < 0.001; left-ventricular end-systolic diameter: OR 0.86 95% CI 0.78-0.95, p = 0.0035), and lower left-ventricular end-diastolic and end-systolic volume (OR 0.72 95% CI 0.65, 0.80, p < 0.001 and OR 0.80 95% CI 0.72, 0.89, p < 0.001). In women, the associations of ER with left ventricular diameters and volumes showed a similar direction, but were not as pronounced. In the community, the ER pattern predominantly occurs in men with a low heart rate and a slender habit. Furthermore, ER is not associated with higher left ventricular mass or size but rather with smaller left ventricular diameters and volumes with a regular systolic and diastolic function. Patterns were comparable in women, but less strong.

Analysis of early repolarization in 621 competitive Algerian athletes

The aim of our work is to study early repolarization (ER) in athletes and comparing between the end QRS slurring and notching. Our study population consists of 621 competitive athletes of both sexes aged 12 to 48 with an average age of 17.4 years. The statistical study used the chi-square test for the comparison of the proportions and the analysis of the variance analysis (ANOVA) for the comparison of the averages. The significance level was set at 5%. The prevalence of ER according to the new diagnostic criteria is 26.1%. With a clear masculine predominance. This prevalence increases with age, reaching its maximum in the third decade, and then decreases. The prevalence of ER is higher in athletes with bradycardia and with a Sokolow-Lyon index greater than 35 mm. No relationship was found for the Cornell index. The prevalence of ER is significantly lower in athletes with an incomplete right bundle branch block. The ER are located in the inferior leads in 40.7%, lateral in 34.6% and both in 24.7%. This distribution of topographies of ER is not influenced by age and gender. The notching is the predominant pattern whatever the topography of ER (notching, 57.4%; slurring, 18.5%; both, 24.1%). The notching predominate on lateral leads (52.3%) while the slurring on inferior leads (68.1%). Only the notching was significantly associated with the male gender (23.8% vs. 5.7%, P < 0.001) bradycardia (41.4% vs. 16%, P < 0.001) and was influenced by the physical training. The prevalence of notching and slurring is significantly higher in athletes with a pathological Sokolow-Lyon index. ERs with an amplitude ≥ 2 mm are 31.8% and 30.7% of ERs have an elevation of a concave and ascending ST segment. We found a prevalence of ER of 26.1%. The inferior topography is the most frequent and the notching is the predominant aspect.

Progression of early repolarization patterns at a four year follow-up in a female flight crew population: Implications for aviation medicine.

To assess the prevalence, the appearance, and the distribution, as well as the fluctuation over time of early repolarization patterns after four years in a female population derived from the French aviation sector. This was a retrospective longitudinal study from 1998 to 2010 of a population of female employees who received a full clinical examination and an electrocardiogram (ECG) upon their recruitment and after a period of four years. A total of 306 women were included (average of 25.87±3.3years of age). The prevalence of early repolarization was 9.2%. The most common appearance was J-point slurring for 64.3% (i.e. 20/28 subjects) that occurred in the inferior leads for 28.6% (i.e. 8/28 subjects). After four years, the prevalence was 7.5%, with a regression of this aspect in five of the subjects. There were no changes in the ECG in terms of the distribution and the appearance among the 23 subjects for whom the aspect persisted. Over the course of this four year period all of the subjects remained asymptomatic. Early repolarization in this largely physically inactive female population was common, and it fluctuated over time. At present, no particular restrictions can be placed on asymptomatic flight crew who exhibit this feature in the absence of a prior medical history for heart disease.

Ventricular and Supraventricular Ectopy in Subjects With Early Repolarization

Early repolarization (ER) is a common electrocardiographic (ECG) finding that is associated with an increased risk of idiopathic ventricular fibrillation and sudden cardiac death. This study investigated whether the presence of ER is a predictor of ventricular and supraventricular ectopy as a marker for electrical instability. Standard 12-lead electrocardiograms of the first follow-up in the population-based Study of Health in Pomerania (SHIP-1) (n= 3,300, age 20 to 79years) were analyzed to identify subjects with an ER pattern. Ventricular and supraventricular ectopy was assessed via portable tele-ECG cards recording 2 electrocardiograms daily over the course of 4weeks. Data of 1,630 subjects (n= 83,833 ECG card recordings, average 51.4 per subject) were analyzed for ventricular and supraventricular ectopy using a standardized automated algorithm. Associations of ER and several forms of arrhythmias were assessed using a 2-sided Fisher's exact test or t test, where appropriate. Overall, prevalence of ER in the SHIP-1 population was 4.8%. Presence of ER was not associated with the occurrence of ventricular and supraventricular arrhythmias (p ≥0.05 for all analyses). Furthermore, subgroup analyzes for ER localization (inferior) and ST-segment morphology (horizontal/descending) did not show any association with arrhythmic events. In conclusion, presence of the ER pattern is not associated with an increased occurrence of ventricular or supraventricular arrhythmias as assessed by serial ECG card recordings in this large population-based sample.

493 - Prevalence of early repolarization in children

493 - Prevalence of early repolarization in children

Early repolarization patterns associated with increased arrhythmic risk are common in young non-Caucasian Australian males and not influenced by athletic status.

Early repolarization (ER) with a horizontal ST segment (ST-h) and high-amplitude J waves in the inferior leads is associated with an increased risk of cardiac arrhythmic death. The effect of ethnicity and athletic status on this increased-risk ER pattern has not been established. Aboriginal Australian/Torres Strait Islander and Pacific Islander/Maori (non-Caucasian [non-C]) subjects are well represented in Australian sport; however, the patterns and prevalence of ER in these populations are unknown. The purpose of this study was to assess the prevalence and effect of athletic activity on ER patterns in young non-C and Caucasian (C) subjects. Twelve-lead ECGs of 726 male athletes (23.8% non-C) and 170 male controls (45.9% non-C) aged 16-40 years were analyzed for the presence of ER, defined as J-point elevation (J wave, QRS slur, or discrete ST elevation) ≥0.1 mV in ≥2 inferior (II, III, aVF) or lateral (I, aVL,V4-V6) leads. ST morphology was coded as horizontal (ST-h) or ascending (ST-a). "Increased-risk ER" was defined as inferior ER with ST-h and J waves >2 mV. Regardless of athletic status, ER and increased-risk ER were more prevalent in non-C than in C subjects (53.8% vs 32% and 7.6% vs 1.2%, respectively, P <.0001). Whereas lower heart rate, larger QRS voltage, and shorter QRS duration were predictors of ER, non-C ethnicity was the only independent predictor of increased-risk ER (odds ratio 17.621, 95% confidence interval 4.98-62.346, P < .0001). ER patterns associated with increased arrhythmic risk are more common in young non-C than C subjects and were not influenced by athletic status. The long-term clinical significance of ER in these populations is yet to be determined.

0395: Prevalence of early repolarization in congenital long QT syndrome. A combination of early and delayed repolarization

early repolarization (ER) in Brugada or short QT syndrome is common and has been associated with a less favourable outcome. Even if apparently paradoxical, ER can also be seen in long QT (LQT) but prevalence and correlations to other variables are unknown. ECG of 105 LQT patients (44 men, 36±21 yo) and 269 age and gender matched controls (135 men, 36±18 yo) were reviewed. LQT was diagnosed by a positive genetic testing (n=71) or by showing abnormal T wave and long QT interval spontaneously or during epinephrin infusion in pts without discovered genetic mutation (n=34). ER was defined by > 1mm J point elevation in the inferior or lateral leads with notch or slurring pattern. QT in lead II was 433±68 msec in LQT patients and 338±41 in controls (p<0.0001) (QTc 446±52 versus 377±30 msec, p<0.0001). Heart rate wq lower in LQT patients (66±14 vs 79±19 bpm) (p<0.0001). Twenty LQT patients presented with resuscitated sudden death or torsades de pointes and 11 with syncope. 33/105 LQT patients (31%) had ER compared to 31/269 (12%) controls (p<0.0001). ER was more frequent in LQT men (19/44, 43%) compared to women (14/61, 23%) (p=0.03) but was not correlated to age (41±20 yo with ER vs 35±21 bpm, p=0.17). LQT patients with ER had lower heart rates (61±11 vs 69±15 bpm, p=0.02). There was a trend toward longer QT in patients with ER (449±73 versus 426±64 msec in lead II, p=0.1) but not for corrected QT intervals (442±48 versus 448±54 msec, p=0.5). There was more frequent ER in case of HeRG (14/26) than KCNQ1 (6/34) or KCNJ2 (2/10) mutations (p=0.008). ER in LQT patients was not correlated to symptoms or cardiac events (5/20 patients with SD, 3/11 in patients with syncope and 25/72 asymptomatic LQT) (p=0.6). ER is very common in LQT patients and is related to the gender and to the heart rate but not to age or to the corrected QT duration. ER is not correlated to cardiac events in this series but may is to HeRG mutations

Increased prevalence of early repolarization in electrocardiograms of psoriatic patients.

Psoriasis (Ps) is a chronic-relapsing, inflammatory, and proliferative condition of the skin: prior studies hypothesized a link between Ps and anomalies in β-adrenergic tone. We therefore aimed to ascertain the prevalence of early repolarization pattern (ERP) in resting electrocardiograms (ECGs) of psoriatic patients compared with an appropriate control group. We performed a retrospective study of resting ECGs of 100 consecutive psoriatic patients and 100 healthy controls. The presence of ERP in at least two contiguous leads at rest ECG was recorded, and findings were also categorized according to the lead group where ERP was detected (anterior, lateral, inferior). An ERP in ≥ 2 contiguous leads occurred in 40 % of psoriatic patients, compared with 14 % of control subjects (p < 0.001). (36 vs 10 % in anterior leads, p < 0.001; 6 vs 3 % in inferior leads, p n.s.; 10 vs 2 % in lateral leads). After adjustment for sex, age, heart rate, and level of physical activity, the odds ratios for the presence of ERP were 8.6 (95 % CI, 2.1-35.2, p < 0.01), and 7.1 (95 % CI, 1.6-31.8, p < 0.05) in anterior leads. In a small case/control study, increased rates of ECGs showing ERP have been observed among psoriatic patients. Clinical significance of such finding needs to be assessed in further observational studies.

Prevalence and electrocardiographic characteristics of early repolarization pattern in young teen athletes

Introduction Early repolarization (ERP) is a common electrocardiographic finding. Its potential to cause cardiac arrhythmias has been hypothesized from experimental studies, but it is not known whether there is a clinical association with sudden cardiac arrest.Methods 122 subjects (100% males; mean age: 13.5± 2.7 years) were included from a local youth soccer team in Belgium. All subjects underwent physical examination and a 12-lead ECG was taken. The main objective of the study was to evaluate early repolarization patterns and to determine its prevalence.Results Of the 122 included subjects, 1 subject with Coumel tachycardia was excluded. The overall prevalence of ERP in our study population was 36%, with 9.1% in the inferior leads, 8.2% in the lateral leads and 18.2% both leads. A family history of sudden cardiac death (SCD) was not higher in the group of ERP (N = 3; 6.8%) compared to the non-ERP group (N = 4; 5.2%) (P = 0.713). Interestingly, incomplete right bundle-branch block (IRBBB) was signifi cantly lower among all subjects with ERP (N = 15; 34.1%), compared to those without ERP (N = 49; 63%) (P < 0.002).Conclusion ERP is a common finding in young teen athletes. In this population global ERP (both inferior and lateral) is more common than isolated inferior or lateral ERP. Young age might be a contributing factor in causing a more diff use repolarization abnormality.

Prevalence of early repolarization in congenital long QT syndrome. A combination of early and delayed repolarization

Introduction: Early Repolarization (ER) in Brugada or short QT syndrome is common and has been associated to a less favourable outcome. Even if apparently paradoxical, ER can also be seen in Long QT (LQT) but prevalence and correlations to other variables are unknown. Methods: 12 leads ECG of 41 LQT patients (21 men, 37±22 yo) were reviewed and compared to 97 matched controls (54 men, 39±24 yo) LQT patients were selected by a positive genetic testing (n=33) or by showing abnormal T wave and long QT interval spontaneously or during epinephrin infusion in patients without discovered genetic mutation (n=8). ER was defined by ≥ 1 mm J point elevation in the inferior or lateral leads with a notch or slurring pattern. Presence of ER was correlated to the clinical and ECG characteristics and to the results of genetic analysis. Results: QT was 406±52 msec in LQT patients and 354±42 in controls (p≤0.0001) (QTc 433±34 versus 386±26 msec, p≤0.0001). Two LQT patients presented with ressuscitated sudden death and 4 with syncope at the time of diagnosis. 14/41 LQT patients (34%) had ER compared to 14/97 (14%) controls (p=0.008). Heart rate was not different between patients and controls (64±10bpm versus 73±20bpm, p=0.14). ER was more frequent in men (12/21, 57%) compared to women (2/20, 10%) (p=0.004) but was not correlated to age (41±22 yo with ER versus 35±22bpm, p=0.4). ER was not correlated to symptoms or cardiac events (no ER in the 2 patients with SD and in 2/4 patients with syncope versus 12/35 in asymptomatic LQT patients, p=ns). There was a trend toward longer QT in patients with ER (427±40 versus 396±54 msec in V2, p=0.09) but there was no correlations between ER and corrected QT intervals. This can be explained by the lower heart rate in patients with ER (63±10 versus 75±18bpm, p=0.03). ER was not more often seen in patients with or without mutations (11/33 versus 3/8, p=0.8), but there was more frequent ER in case of HeRG mutations (9/17) than in case of KCNQ1 or KCNJ2 mutations (2/13 and 0/3) (p=0.04) Conclusion: ER is very common in LQT patients and is related to a male gender, to a longer QT duration and to a slower heart rate but not to age or to the corrected QT duration. ER does not seem to be correlated to cardiac events in this series but may be linked to HeRG mutations. Further studies are needed for demonstrating additional mutations/variants or the existence of an early transient voltage gradient due to altered kinetics in muted potassium channels with loss of function especially for HeRG mutations.

Prognostic significance of early repolarization in inferolateral leads in Brugada patients with documented ventricular fibrillation: A novel risk factor for Brugada syndrome with ventricular fibrillation

Little is known about the clinical and prognostic impact of early repolarization (ER) on patients with Brugada syndrome (BrS), especially those with documented ventricular fibrillation (VF). To investigate the prevalence and prognostic significance of ER in inferolateral leads in patients with BrS and documented VF. We investigated 10 different 12-lead electrocardiograms (ECGs) recorded on different days to identify the presence of ER, which was defined as J-point elevation ≥0.1 mV in inferior (II, III, aVF) or lateral leads (I, aVL, V₄-V₆), in 49 individuals (46 men; age 46 ± 13 years) with a type 1 ECG of BrS and previous history of VF. ER was observed persistently (in all ECGs) in 15 patients (31%; P group), intermittently (in at least one but not in all ECGs) in 16 patients (33%; I group), and not observed in 18 patients (37%; N group), yielding an overall ER incidence of 63% (31/49). During the follow-up period (7.7 years), recurrence of VF was documented in all 15 patients (100%) in the P group, and less in 12 patients (75%) in the I group and in 8 patients (44%) in the N group. The P group showed a worse prognosis than N group (P = .0001) by Kaplan-Meier analysis. Either persistent or intermittent ER in an inferolateral lead was an independent predictor of fatal arrhythmic events (hazard ratio 4.88, 95% confidence interval 2.02-12.7, P = .0004; and hazard ratio 2.50, 95% confidence interval 1.03-6.43, P = .043, respectively). The prevalence of ER in inferolateral leads was high and an especially persistent form of ER was associated with a worse outcome in BrS patients with documented VF.

Abstract MP44: Biomarker Measures of Fish-Derived Omega-3 Fatty Acids and J-Point Elevation in the Atherosclerosis Risk in Communities (ARIC) Study

Background: Higher intake of fish-derived omega-3 polyunsaturated fatty acids (PUFAs) has been associated with lower incidence of Sudden Cardiac Death (SCD), but the exact mechanisms underlying this association are unconfirmed. Early ventricular repolarization characterized by an elevation of the QRS-ST junction (J-Point) in the surface ECG has been associated with idiopathic ventricular fibrillation, the most common cause of SCD. We aimed to study the association of fish-derived PUFAs in plasma with the prevalence of J-Point elevation. Methods: We conducted a cross-sectional analysis of participants aged 45-64 (45.7% male, 100% whites) from the Minnesota Field Center of the Atherosclerosis Risk in Communities (ARIC) Study. Participants were excluded if they did not have an ECG, had a QRS duration ≥ 120 ms, were taking Class I or Class III antiarrhythmic agents, or had prevalent cardiovascular disease. Fish-derived PUFAs were measured in plasma phospholipids as a percentage of total fatty acids, categorized into quartiles, and logistic regression was used to estimate the odds of J-Point Elevation, defined as elevation of greater than 100 microvolts in at least two contiguous leads. Models were adjusted for potential confounders and tests of linear trend were conducted by assigning the median values for each exposure category and modeling as a continuous variable. Results: Among 3,330 eligible individuals, 126 presented J-Point elevation. Median fish-derived fatty acid percentage was 3.2% (range: 0.7-12.2). Using multivariable analyses, plasma measures of fish-derived omega-3 PUFAs were linearly associated with the log odds of J-Point elevation with increasing fatty acid percentages associated with lower odds of J-Point elevation (see Table). Conclusions: In this population, higher plasma levels of fish-derived PUFAs were inversely associated with J-Point elevation. Fish-derived PUFAs could reduce risk of SCD through decreased prevalence of early repolarization.

The prevalence of lateral lead early repolarization in otherwise normal electrocardiograms as a function of age

The prevalence of early repolarization in otherwise normal electrocardiograms as a function of age was evaluated in 2335 Veteran male patients. Thirty-one percent of the patients <35years of age had early repolarization, whereas only 5% of patients >65years of age demonstrated this phenomenon. In addition, only 12% of female patients <35years of age had early repolarization.

Natural history of the early repolarization pattern in a biracial cohort: CARDIA (Coronary Artery Risk Development in Young Adults) Study.

The objective of this analysis was to determine the natural history and prospective association of cardiovascular risk factors with early repolarization (ER). ER is common and has been suggested to increase risk for cardiovascular mortality in middle-aged adults. Data are sparse regarding the natural history of ER from young adulthood to middle age. We examined 5,069 participants (mean age 25 years at baseline; 40% black) from the CARDIA (Coronary Artery Risk Development in Young Adults) cohort over 20 years. Electrocardiograms were recorded at years 0 (Y0), 7 (Y7), and 20 (Y20) and coded as either definite, probable, possible, or no ER. Logistic regression was used to determine the association of cardiovascular risk factors with the presence of ER cross-sectionally and prospectively. A total of 941 of the 5,069 participants (18.6%) had definite ER at baseline, and only 119 of 2,505 participants (4.8%) at the Y20 examination still demonstrated the presence of ER. Younger age, black race, male sex, longer exercise duration and QRS duration, and lower body mass index (BMI), heart rate, QT index, and Cornell voltage were associated cross-sectionally with the presence of ER. Predictors of maintenance of ER from Y0 to Y20 were black race (odds ratio [OR]: 2.62; 95% CI; 1.61 to 4.25), BMI (OR: 0.62 per 1 SD; 95% CI: 0.40 to 0.94), serum triglyceride levels (OR: 0.66 per 1 SD; 95% CI: 0.45 to 0.98), and QRS duration (OR: 1.68 per 1 SD; 95% CI: 1.37 to 2.06) at baseline. The prevalence of ER was significantly higher than previous estimates among asymptomatic young adults, and the majority of ER regressed by middle age. Black race, lower BMI, lower serum triglyceride levels, and longer QRS duration were independently associated with maintenance of ER over time.

188: Prevalence of early repolarization in congenital long QT syndrome A combination of early and delayed repolarization

early repolarization (ER) in Brugada or short QT syndrome is common and has been associated to a less favourable outcome. Even if apparently paradoxical, ER can also be seen in long QT (LQT) but prevalence and correlations to other variables are unknown. 12 lead ECG of 37 LQT pts (19 men, 39±21 yo) and 80 matched controls were reviewed. LQT pts were selected by a positive genetic testing (n=27) or by showing abnormal T wave and long QT interval (n=10) either spontaneously or during epinephrin infusion. ER was defined by >1 mm J point elevation in the inferior or lateral leads with notch or slurring pattern. Presence of ER was correlated to the clinical and ECG characteristics and results genetic analysis. QT was 409±53 msec in pts and 372±24 in controls (p<0.0001) (QTc 476±52 vs 392±26 msec, p<0.0001). Two LQT pts presented with resuscitated sudden death and 4 with syncope at the time of diagnosis. 14/37 LQT pts (38%) had ER compared to 17/80 (21%) controls (p=0.05). ER was more frequent in men (12/19, 63%) compared to women (2/18, 11%) (p=0.001) but was not correlated to age. Pts with ER had slower heart rate (63±10 vs 75±18 bpm, p=0.02). ER was not correlated to symptoms or cardiac events (no ER in the 2 pts with SD and in 2/4 pts with syncope). QT were longer in pts with ER (450±68 vs 397±54 msec in V2, p=0.01) but there was no correlations between ER and corrected QT intervals. ER was more often seen in pts with or without mutations although non significantly (8/27 vs 6/10, p=0.09), but there was a trend toward more frequent ER in case of HeRG mutations (6/12) than KCNQ1 or KCNJ2 mutations (2/11 and 0/4) (p=0.09). ER is very common in LQT pts and is related to the gender and to the heart rate but not to the corrected QT duration. ER does not seem to be correlated to cardiac events in this series but may be linked to some gene mutations. Further studies are needed for demonstrating additional mutations/ variants or the existence of an early transient voltage gradient due to altered kinetics in muted potassium channels with loss of function.

我が国の体育系大学生における早期再分極の検討

【背景】12誘導心電図のJ波やST上昇は早期再分極所見とされ，アスリートに多く，心臓性急死との関連が問題となっている．一方，我が国の体育系大学生における早期再分極所見率や特徴は報告されていない．【目的】我が国の体育系大学生における早期再分極（J波）所見の頻度を非体育系大学生と比較検討する．【方法】本学スポーツ健康科学部学生（Sports群）362名，医学部学生（Control群）123名（18±1歳）の心電図において，2誘導以上でJ波が基線から0.1mV以上の上昇を示す所見を早期再分極と定義し，下壁誘導（II,III, aVF），側壁誘導（I, aVL, V4, V5, V6）および両誘導について比較した．【結果】早期再分極所見率はSports群がControl群に比べ高い傾向を示したが（14.6 ％ vs. 10.6％，p＜0.26），有意差はなかった．また，下壁誘導（8.0％ vs. 5.7％，p＜0.40），側壁誘導（4.1％ vs. 4.1％，p＜0.97），両誘導（2.5％ vs. 0.8％，p＜0.26）も有意差はなかった．Sports群の早期再分極所見は短いQTc（OR, 5.42；95％ CI, 1.58～18.64；p＜0.01），心電図上の左心室肥大（OR, 3.35；95％ CI, 1.75～6.39；p＜0.001）および低い心拍数（OR, 2.32；95％ CI, 1.23～4.39；p＜0.01）が有意に関連していた．【結語】我が国の体育系大学生の早期再分極所見率は，非体育系大学生の所見率と統計上の差がなかった．