TY - JOUR
T1 - Early repolarization pattern in competitive athletes
T2 - Clinical correlates and the effects of exercise training
AU - Noseworthy, Peter A.
AU - Weiner, Rory
AU - Kim, Jonathan
AU - Keelara, Varsha
AU - Wang, Francis
AU - Berkstresser, Brant
AU - Wood, Malissa J.
AU - Wang, Thomas J.
AU - Picard, Michael H.
AU - Hutter, Adolph M.
AU - Newton-Cheh, Christopher
AU - Baggish, Aaron L.
PY - 2011/8
Y1 - 2011/8
N2 - Background-Inferior lead early repolarization pattern (ERP) recently has been associated with sudden cardiac death. Although ERP is common among athletes, prevalence, ECG lead distribution, clinical characteristics, and effects of physical training remain uncertain. We sought to examine the nonanterior ERP in competitive athletes. Methods and Results-ERP was assessed in a cross-sectional cohort of collegiate athletes (n=879). The relationship between ERP and cardiac structure were then examined in a longitudinal subgroup (n=146) before and after a 90-day period of exercise training. ERP was defined as J-point elevation ≥0.1 mV in at least 2 leads within a nonanterior territory (inferior [II, III, aVF] or lateral territory [I, aVL, V4-V6]). Nonanterior ERP was present in 25.1% (221/879) of athletes, including the inferior subtype in 3.8% (33/879). Exercise training led to significant increases in the prevalence of ERP and the inferior subtype, but there were no associations between ERP and echocardiographic measures of left ventricular remodeling. In a multivariable model, ERP was associated with black race (odds ratio [OR], 5.84; 95% CI, 3.54 to 9.61; P<0.001), increased QRS voltage (OR, 2.08; 95% CI, 1.71 to 2.52; P<0.001), and slower heart rate (OR, 1.54; 95% CI, 1.26 to 1.87; P<0.001). Conclusions-Nonanterior ERP, including the inferior subtype, is common and has strong clinical associations among competitive athletes. The finding of increased ERP prevalence after intense physical training establishes a strong association between exercise and ERP.
AB - Background-Inferior lead early repolarization pattern (ERP) recently has been associated with sudden cardiac death. Although ERP is common among athletes, prevalence, ECG lead distribution, clinical characteristics, and effects of physical training remain uncertain. We sought to examine the nonanterior ERP in competitive athletes. Methods and Results-ERP was assessed in a cross-sectional cohort of collegiate athletes (n=879). The relationship between ERP and cardiac structure were then examined in a longitudinal subgroup (n=146) before and after a 90-day period of exercise training. ERP was defined as J-point elevation ≥0.1 mV in at least 2 leads within a nonanterior territory (inferior [II, III, aVF] or lateral territory [I, aVL, V4-V6]). Nonanterior ERP was present in 25.1% (221/879) of athletes, including the inferior subtype in 3.8% (33/879). Exercise training led to significant increases in the prevalence of ERP and the inferior subtype, but there were no associations between ERP and echocardiographic measures of left ventricular remodeling. In a multivariable model, ERP was associated with black race (odds ratio [OR], 5.84; 95% CI, 3.54 to 9.61; P<0.001), increased QRS voltage (OR, 2.08; 95% CI, 1.71 to 2.52; P<0.001), and slower heart rate (OR, 1.54; 95% CI, 1.26 to 1.87; P<0.001). Conclusions-Nonanterior ERP, including the inferior subtype, is common and has strong clinical associations among competitive athletes. The finding of increased ERP prevalence after intense physical training establishes a strong association between exercise and ERP.
KW - Electrocardiography
KW - Electrophysiology
KW - Exercise
UR - http://www.scopus.com/inward/record.url?scp=80054011501&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=80054011501&partnerID=8YFLogxK
U2 - 10.1161/CIRCEP.111.962852
DO - 10.1161/CIRCEP.111.962852
M3 - Article
C2 - 21543642
AN - SCOPUS:80054011501
SN - 1941-3149
VL - 4
SP - 432
EP - 440
JO - Circulation: Arrhythmia and Electrophysiology
JF - Circulation: Arrhythmia and Electrophysiology
IS - 4
ER -