The Early Repolarization Pattern in the General Population: Clinical Correlates and Heritability

• Published in: Journal of the American College of Cardiology Vol. 57; no. 22; pp. 2284 - 2289
• Main Authors: NOSEWORTHY, Peter A, TIKKANEN, Jani T, HWANG, Shih-Jen, O'DONNELL, Christopher J, SALOMAA, Veikko, NEWTON-CHEH, Christopher, HUIKURI, Heikki V, PORTHAN, Kimmo, OIKARINEN, Lasse, PIETILÄ, Arto, HARALD, Kennet, PELOSO, Gina M, MERCHANT, Faisal M, JULA, Antti, VÄÄNÄNEN, Heikki
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier 31.05.2011; Elsevier Limited
• Subjects: Adult; Age; Aged; Arrhythmias, Cardiac - diagnosis; Arrhythmias, Cardiac - genetics; Arrhythmias, Cardiac - physiopathology; Biological and medical sciences; Blood pressure; Cardiology; Cardiology. Vascular system; Confidence intervals; Death, Sudden, Cardiac - epidemiology; Electrocardiography; Estimates; Female; Heart; Heart Conduction System - pathology; Heart Conduction System - physiopathology; Humans; Logistics; Male; Medical sciences; Mens health; Middle Aged; Population; Regression Analysis; Siblings; Syndrome; Triglycerides; Repolarization; Pathogenesis; Population; Early; Circulatory system; Cardiology; Genetic determinism
• ISSN: 0735-1097; 1558-3597; 1558-3597
• DOI: 10.1016/j.jacc.2011.04.003

This study sought to describe the clinical correlates and heritability of the early repolarization pattern (ERP) in 2 large, population-based cohorts. There is growing recognition that ERP is associated with adverse outcomes. Participants of the Framingham Heart Study (FHS) (N = 3,995) and the Health 2000 Survey (H2K) (N = 5,489) were included. ERP was defined as a J-point elevation ≥0.1 mV in ≥2 leads in either the inferior (II, III, aVF) or lateral (I, aVL, V(4-6)) territory or both. We tested the association between clinical characteristics and ERP, and estimated sibling recurrence risk. ERP was present in 243 of 3,955 (6.1%) of FHS and 180 of 5,489 (3.3%) of H2K subjects. Male sex, younger age, lower systolic blood pressure, higher Sokolow-Lyon index, and lower Cornell voltage were independently associated with the presence of ERP. In the FHS sample, siblings of individuals with ERP had an ERP prevalence of 11.6% (recurrence risk ratio of 1.89). Siblings of individuals with ERP had an increased unadjusted odds of ERP (odds ratio: 2.22, 95% confidence interval: 1.01 to 4.85, p = 0.047). ERP has strong association with clinical factors and has evidence for a heritable basis in the general population. Further assessment of the genetic determinants of ERP is warranted.