Background and Objectives: Early repolarization pattern (ERP) has recently been shown to be related with an increased risk of ventricular arrhythmias in susceptible individuals. Materials and Methods: We studied the ERP-associated ECG changes, with potential clinical relevance, in 220 young (age 22.1 ± 1.6 years), healthy, male subjects using 12-lead ECG recordings. A total of 38 subjects (17.3%) fulfilled the diagnostic criteria for ERP, and a total of 90 ECG characteristics were compared between the groups of subjects with and without ERP. Results: None of the ECGs were pathological, and 22 ECG parameters differed significantly (p < 0.05) between the subjects with and without ERP. Among them, the P wave-related parameters (e.g., average P wave duration: 101.5 ± 9.2 ms vs. 106.8 ± 9.9 ms, p = 0.004) and the presence of fragmented QRS complexes (67.6% vs. 92.1%, p = 0.002) revealed a potential propensity for atrial and ventricular arrhythmogenesis. The time-domain parameters of repolarization, those not corrected for QRS duration, showed shorter values (e.g., Tpeak-Tend interval: 70.9 ± 8.1 ms vs. 67.8 ± 8.0 ms, p = 0.036), reflecting the accelerated repolarization. Conclusions: Certain ECG characteristics seem to be more associated with ERP. The clinical significance of this finding at the individual level needs further prospective investigations.
Összefoglaló. Bevezetés: Az EKG-n megjelenő korai repolarizációs mintázat diagnosztikai kritériumai és klinikai jelentősége elsősorban az elmúlt évtizedben került tisztázásra, ugyanakkor viszonylag kevés vizsgálat foglalkozott mind ez idáig a korai repolarizációs mintázathoz köthető esetleges strukturális szívelváltozások felderítésével. Módszer: Egy prospektív vizsgálat során azonosított 30, korai repolarizációs mintázatot mutató fiatal férfi (átlagéletkor: 22,5 ± 1,5 év) echokardiográfiás paramétereit hasonlítottuk össze egy 32 főből álló (átlagéletkor: 22,3 ± 1,9 év) megfeleltetett kontrollcsoport azonos jellemzőivel. A hagyományos paraméterek mérésén túlmenően, szöveti Doppler- és ’strain’ (deformáció – speckle tracking módszerrel) vizsgálatot is végeztünk, összesen 35 jellemzőt követve. A paraméterek összehasonlítása kétmintás t-próba, illetve khi-négyzet-próba segítségével történt (szignifikancia: p<0,05). Eredmények: Nem találtunk patológiás elváltozásokat egyik személy esetében sem, és a két csoport között csupán két paraméter tekintetében fedeztünk fel szignifikáns eltérést. A korai repolarizációs mintázatot mutató csoportban kisebbnek bizonyult a bal kamra végsystolés térfogata (37,6 ± 15,2 ml vs. 45,5 ± 13,4 ml; p = 0,037), illetve gyakoribbnak találtuk az enyhe mitralis regurgitatio előfordulását (41,4% vs. 6,5%; p<0,001). Következtetés: A korai repolarizációs mintázatot mutató fiatal férfiak esetén kimutathatók bizonyos echokardiográfiás jellegzetességek. Ezek időbeli alakulásának, illetve prognosztikai, aritmológiai jelentőségének megítélése további, longitudinális követést igényel. Orv Hetil. 2021; 162(19): 741–745. Summary. Introduction: The diagnostic criteria and clinical significance of early repolarization pattern on ECG were clarified mainly in the last decade. However, there are only a few studies published on the exploration of cardiac structural changes underlying early repolarization pattern. Method: We compared the echocardiographic parameters of 30 young males with early repolarization pattern (mean age: 22.5 ± 1.5 years), who were identified during a prospective survey, with the same parameters of a matched control group consisting of 32 young males (mean age: 22.3 ± 1.9 years). Beyond measuring the conventional parameters, tissue Doppler and strain measures (speckle tracking) were obtained. Comparison of parameters was performed using t-test and chi-square test (significancy: p<0.05). Results: There were no pathological changes in any person, and we found significant difference between the two groups only in the case of two parameters. In the early repolarization pattern group, the left ventricular end-systolic volume was smaller (37.6 ± 15.2 ml vs. 45.5 ± 13.4 ml; p = 0.037) and the presence of mild mitral regurgitation was more frequent (41.4% vs. 6.5%; p<0.001). Conclusion: In young males with early repolarization pattern, we managed to demonstrate the existence of certain echocardiographic features. The assessment of their time course, prognostic and arrhythmological significance requires a longer follow-up. Orv Hetil. 2021; 162(19): 741–745.
Background Early repolarization pattern (ERP) takes part from the J-wave syndromes and is associated with enhanced ventricular arrhythmogenesis in susceptible individuals. The main reason of our study was, that possible existence of subtle structural and functional cardiac changes related to ERP is still not well estabilished. Methods We compared 32 echocardiographic parameters (standard measures and specle tracking derived strain) of 30 young men (mean age 21.5 years) with ERP and 32 age and body-mass matched young men without ERP. T-test and chi-square test were used for statistical analysis (significant difference if p < 0.05). Results Only the presence of mild mitral regurgitation was significantly more frequent in the ERP group (36.7% vs. 9.5%, p = 0.01). There were no significant differences regarding the other parameters, e.g., the interventricular septum (9.5 mm vs. 9.4 mm, p = 0.97), the end-diastolic diameters of the left and right ventricles (45 mm vs. 46.6 mm, p = 0.11; 34.9 mm vs. 33.8 mm, p = 0.42), the left ventricular ejection fraction ( 62.4% vs. 60.9 %, p = 0,3), the longitudinal diameters of the left and right atrium (51.8 mm vs. 53.1 mm, p = 0.27; 36.8 mm vs. 36.1 mm, p = 0.20), and the left ventricular global longitudinal strain (-21.75% vs. -21.28, p = 0.77). Conclusion In young males with ERP the vast majority of echocardiographic parameters was not different from those measured in their counterparts without ERP. The existence and clinical significance of the more prevalent mild mitral regurgitation in the ERP group has to be confirmed in a larger cohort.
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