Document Detail

Early repolarization pattern in competitive athletes: clinical correlates and the effects of exercise training.
MedLine Citation:
PMID:  21543642     Owner:  NLM     Status:  MEDLINE    
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.
Peter A Noseworthy; Rory Weiner; Jonathan Kim; Varsha Keelara; Francis Wang; Brant Berkstresser; Malissa J Wood; Thomas J Wang; Michael H Picard; Adolph M Hutter; Christopher Newton-Cheh; Aaron L Baggish
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-05-04
Journal Detail:
Title:  Circulation. Arrhythmia and electrophysiology     Volume:  4     ISSN:  1941-3084     ISO Abbreviation:  Circ Arrhythm Electrophysiol     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-08-17     Completed Date:  2011-10-13     Revised Date:  2013-07-19    
Medline Journal Info:
Nlm Unique ID:  101474365     Medline TA:  Circ Arrhythm Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  432-40     Citation Subset:  IM    
Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA.
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MeSH Terms
Arrhythmias, Cardiac / physiopathology*
Cross-Sectional Studies
Death, Sudden, Cardiac / epidemiology
Exercise / physiology*
Longitudinal Studies
Multivariate Analysis
Prospective Studies
Risk Factors
Ventricular Remodeling / physiology
Grant Support
HL080025/HL/NHLBI NIH HHS; K23 HL080025/HL/NHLBI NIH HHS; //Wellcome Trust

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