Comparison of inferolateral early repolarization and its electrocardiographic phenotypes in pre- and postadolescent populations

Solomon J. Sager, Michael Hoosien, M. Juhani Junttila, Tanyanan Tanawuttiwat, Arlette Perry, Robert J Myerburg

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Abstract

Inferolateral early repolarization (ER) patterns on standard electrocardiogram (ECG) are associated with increased risk for cardiac and arrhythmic death in general adult population cohorts. We sought to determine the prevalence of inferolateral ER on surface ECG in multiracial pre- and postadolescent populations and to analyze its association with age, race, gender, and ST-segment patterns. A retrospective review was conducted of all ECGs recorded from preadolescent (aged 8-12 years, n = 719) and postadolescent (aged 21-25 years, n = 755) patients seen at a large academic medical center between January 1, 2009, and December 31, 2010. The overall prevalence of inferolateral ER was similar in the preadolescent and postadolescent populations (17% vs 16%, NS). The prevalence of ER increased after puberty in male patients (16% to 25%, p <0.001) and decreased in female patients (18% to 9%, p <0.001). Prevalence of ascending early repolarization (benign variant) also increased in males after puberty (15% to 23%, p <0.004) and decreased in females (11% to 4%, p <0.001). There were no differences in the prevalence of the risk-associated horizontal/descending pattern (3% in both groups). Subgroup analysis was performed on ECGs from the cohort of outpatients without cardiac disease, and the statistical trends remained the same. In conclusion, the overall prevalence of inferolateral ER was higher in pre- and postadolescent populations than in adult populations. However, the prevalence of the risk-associated horizontal/descending ST-segment pattern was only 3%, comparable to prevalence rates in the adult population. The variations in prevalence by gender and age suggest a possible influence of reproductive hormones.

Original languageEnglish
Pages (from-to)444-448
Number of pages5
JournalAmerican Journal of Cardiology
Volume112
Issue number3
DOIs
StatePublished - Aug 1 2013

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Phenotype
Population
Electrocardiography
Puberty
Heart Diseases
Outpatients
Hormones

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Comparison of inferolateral early repolarization and its electrocardiographic phenotypes in pre- and postadolescent populations. / Sager, Solomon J.; Hoosien, Michael; Junttila, M. Juhani; Tanawuttiwat, Tanyanan; Perry, Arlette; Myerburg, Robert J.

In: American Journal of Cardiology, Vol. 112, No. 3, 01.08.2013, p. 444-448.

Research output: Contribution to journalArticle

Sager, Solomon J. ; Hoosien, Michael ; Junttila, M. Juhani ; Tanawuttiwat, Tanyanan ; Perry, Arlette ; Myerburg, Robert J. / Comparison of inferolateral early repolarization and its electrocardiographic phenotypes in pre- and postadolescent populations. In: American Journal of Cardiology. 2013 ; Vol. 112, No. 3. pp. 444-448.
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abstract = "Inferolateral early repolarization (ER) patterns on standard electrocardiogram (ECG) are associated with increased risk for cardiac and arrhythmic death in general adult population cohorts. We sought to determine the prevalence of inferolateral ER on surface ECG in multiracial pre- and postadolescent populations and to analyze its association with age, race, gender, and ST-segment patterns. A retrospective review was conducted of all ECGs recorded from preadolescent (aged 8-12 years, n = 719) and postadolescent (aged 21-25 years, n = 755) patients seen at a large academic medical center between January 1, 2009, and December 31, 2010. The overall prevalence of inferolateral ER was similar in the preadolescent and postadolescent populations (17{\%} vs 16{\%}, NS). The prevalence of ER increased after puberty in male patients (16{\%} to 25{\%}, p <0.001) and decreased in female patients (18{\%} to 9{\%}, p <0.001). Prevalence of ascending early repolarization (benign variant) also increased in males after puberty (15{\%} to 23{\%}, p <0.004) and decreased in females (11{\%} to 4{\%}, p <0.001). There were no differences in the prevalence of the risk-associated horizontal/descending pattern (3{\%} in both groups). Subgroup analysis was performed on ECGs from the cohort of outpatients without cardiac disease, and the statistical trends remained the same. In conclusion, the overall prevalence of inferolateral ER was higher in pre- and postadolescent populations than in adult populations. However, the prevalence of the risk-associated horizontal/descending ST-segment pattern was only 3{\%}, comparable to prevalence rates in the adult population. The variations in prevalence by gender and age suggest a possible influence of reproductive hormones.",
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