Background: Early repolarization pattern (ERP) on electrocardiogram (ECG) is a relatively common !nding in the general population. ERP, especially in the inferior distribution, has been associated with sudden cardiac death. Prior investigation has shown positive correlation between ERP and ECG criteria for left ventricular hypertrophy (LVH) leading many to speculate that there may be associated echocardiographic !ndings. The aim of this study was to examine potential echocardiographic, demographic, and plasma marker associations with ERP in a large, population based cohort. Methods: 1,050 participants in the Baltimore Longitudinal Study of Aging, a National Institute on Aging sponsored initiative, were included in this study. ERP was de!ned as J-point elevation " 0.1mV in "2 leads of any of the following distributions: lateral leads (I, aVL, V4-6), inferior leads (II, III, aVF), or global (both lateral and inferior). Participant ECGs previously obtained and stored were retrieved and interpreted for this study. Standard transthoracic echocardiogram data and comprehensive laboratory results, including serum in#ammatory markers and lipid pro!les, obtained at the time of original ECG collection were analyzed. Results: ERP was present in 83 (7.9%) participants. Lateral, inferior, and global ERP was present in 30 (2.9%), 34 (3.2%), and 19 (1.8%) participants, respectively. Younger age was signi!cantly associated with ERP. After age and gender adjustment, increased left atrial volume index (LAVI) was associated with all ERP and lateral ERP speci!cally (mean LAVI 19 cm3 in non-ERP vs. 27 cm3 in lateral ERP) but not inferior ERP. Neither left ventricular wall thickness nor serum measurements showed association with ERP. Conclusions: Lateral ERP was associated with LAVI enlargement on echocardiographic assessment of this large, community dwelling cohort. Although prior investigation has shown positive correlation between ERP and ECG criteria for LVH, our study did not !nd any association between ERP and left ventricular wall thickness. Further investigation is warranted to corroborate these !ndings and uncover potential mechanistic explanations behind individual ERP subtypes.
ECHOCARDIOGRAPHIC AND CLINICAL CORRELATES OF SPECIFIC EARLY REPOLARIZATION SUBTYPES ON ELECTROCARDIOGRAM
CANEPA, MARCO;
2012-01-01
Abstract
Background: Early repolarization pattern (ERP) on electrocardiogram (ECG) is a relatively common !nding in the general population. ERP, especially in the inferior distribution, has been associated with sudden cardiac death. Prior investigation has shown positive correlation between ERP and ECG criteria for left ventricular hypertrophy (LVH) leading many to speculate that there may be associated echocardiographic !ndings. The aim of this study was to examine potential echocardiographic, demographic, and plasma marker associations with ERP in a large, population based cohort. Methods: 1,050 participants in the Baltimore Longitudinal Study of Aging, a National Institute on Aging sponsored initiative, were included in this study. ERP was de!ned as J-point elevation " 0.1mV in "2 leads of any of the following distributions: lateral leads (I, aVL, V4-6), inferior leads (II, III, aVF), or global (both lateral and inferior). Participant ECGs previously obtained and stored were retrieved and interpreted for this study. Standard transthoracic echocardiogram data and comprehensive laboratory results, including serum in#ammatory markers and lipid pro!les, obtained at the time of original ECG collection were analyzed. Results: ERP was present in 83 (7.9%) participants. Lateral, inferior, and global ERP was present in 30 (2.9%), 34 (3.2%), and 19 (1.8%) participants, respectively. Younger age was signi!cantly associated with ERP. After age and gender adjustment, increased left atrial volume index (LAVI) was associated with all ERP and lateral ERP speci!cally (mean LAVI 19 cm3 in non-ERP vs. 27 cm3 in lateral ERP) but not inferior ERP. Neither left ventricular wall thickness nor serum measurements showed association with ERP. Conclusions: Lateral ERP was associated with LAVI enlargement on echocardiographic assessment of this large, community dwelling cohort. Although prior investigation has shown positive correlation between ERP and ECG criteria for LVH, our study did not !nd any association between ERP and left ventricular wall thickness. Further investigation is warranted to corroborate these !ndings and uncover potential mechanistic explanations behind individual ERP subtypes.
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