The Electrocardiogram in Epidemiological Studies: Reproducibility, Validity, and International Comparison

Higgins, I. T. T.; Kannel, W. B.; Dawber, Thomas R.

doi:10.1136/jech.19.2.53

Cited by 40 publications

(17 citation statements)

References 12 publications

(2 reference statements)

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“…In a large sample of over 100 000 aircrew men aged 16–50 years, Hiss and Lamb24 found AV block in 0.6% of the ECGs, while in the Framingham study,3 prevalences in 30–62 year old men and women were, respectively, 0.7% and 0.8%. The reason why these figures are higher than those observed in our study (0.2% in men, 0.1% in women) is unclear.…”

Section: Discussionmentioning

confidence: 93%

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Prevalences of ECG findings in large population based samples of men and women

Bacquer¹

2000

Heart

185

142

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Objective-To obtain accurate estimates of the prevalence of ECG abnormalities in the general population and to describe them in relation to age, sex, and some lifestyle related factors. Design-The results were obtained from the records of 47 358 men and women participating in four large Belgian epidemiological studies during the past 30 years. All tracings were read and coded by two trained cardiologists on the basis of Minnesota code criteria. Results-Prevalences of coronary heart disease and abnormal ECG findings rose exponentially with age in both sexes, with the exception of atrioventricular block and the WolV-ParkinsonWhite (WPW) syndrome. Major ECG findings were observed in 6.0% of all men and 4.3% of women, resulting in a significant adjusted sex ratio of 1.66 (95% confidence interval 1.46 to 1.88). The prevalence of minor ECG changes was slightly higher among men (10.4% v 9.5% in women). The occurrence of ischaemia-like findings on the ECG was comparable between men and women (9.0% v 9.8%). Independent of age, smoking, obesity, diabetes, employment status, positive history of angina or infarction, and region, there were significantly higher prevalences of Q/QS patterns, left ventricular hypertrophy, left axis deviation, arrhythmias, and atrial fibrillation or flutter in men than in women. Right bundle branch block and WPW syndrome both occurred 3.5 times more often in men, while the prevalence of left bundle branch block was comparable between the sexes. Conclusions-The large sample size allowed a precise description of the most important ECG abnormalities. These are not rare in the adult population and most are strongly age related. Sex diVerences occur with some, but not all, abnormalities. The less common ECG abnormalities were more often observed among men. (Heart 2000;84:625-633)

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Section: Discussionmentioning

confidence: 93%

“…9 10 13 The reported prevalences of Minnesota codes VII 1,2,4 in men range from 1.2% in the Framingham study3 (30–62 years) up to 2.7% in the white men from the Evans County heart study9 (40–64 years). In our study, the observed prevalences of bundle branch block were 1.6% in men and 0.8% in women, the adjusted sex ratio being 2.28.…”

Section: Discussionmentioning

confidence: 99%

Prevalences of ECG findings in large population based samples of men and women

Bacquer¹

2000

Heart

185

142

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“…The CHA study found the prevalence of combined isolated minor NS-STTA (MC 4-3 or 4-4 with MC 5-3 or 5-4 in the same lead) to be significantly higher in women than men (2.0% vs. 0.8%, respectively; P Ͻ 0.001). 11 In the other communitybased cohort studies with data for males and females, 4,11,14,15,17,19,20,22,27 the overall prevalence of minor NSSTTA varied widely, between 1% and 14%, but the median prevalence of minor NSSTTA was higher in women compared with men (Fig. 2); the median prevalence of minor ST-segment depression (any or isolated MC 4-3 and/or 4-4) was 1.0% in white women, when compared with 0.7% in white men, and the median prevalence of minor T-wave abnormalities (any or isolated MC 5-3 and/or 5-4) was 7.2% versus 3.3% in white women versus men.…”

Section: Gender Comparisonmentioning

confidence: 99%

Clinical Significance of Minor Nonspecific ST-Segment and T-Wave Abnormalities in Asymptomatic Subjects: A Systematic Review

Kumar

Lloyd‐Jones

2007

Cardiology in Review

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The purpose of the study is to examine the prevalence and significance of minor nonspecific ST-segment and T-wave abnormalities (NSSTTA) in the prediction of future cardiovascular disease (CVD) events. Minor NSSTTA are commonly encountered in clinical practice. To date, there have been no systematic reviews focusing on the prevalence and prognostic importance of these findings. Literature searches of MEDLINE (1966-2005) were supplemented with searches of bibliographies from key articles. We focused on isolated minor NSSTTA in healthy middle-aged or elderly populations, including men, women, blacks, and whites, and the association of isolated minor NSSTTA with incident cardiovascular and coronary events. Isolated minor NSSTTA are common in middle-aged white men (ranging from 3.6% to 10.3%), and seem to be even more prevalent in women, blacks, and the elderly. In the 3 studies that examined isolated minor NSSTTA, the multivariable-adjusted hazard ratios for coronary mortality ranged from 1.24 to 1.66. Although gender, race, and age-specific differences in the prognostic significance of minor NSSTTA are not clear because of limited data, minor NSSTTA in asymptomatic patients are an important risk factor for coronary and cardiovascular mortality, independent of traditional risk factors. Minor NSSTTA are prevalent in asymptomatic individuals, and they confer increased risk for CVD and coronary heart disease (CHD), independent of traditional risk factors. Future studies with standardized methodology are needed to elucidate the physiological significance of minor NSSTTA and to further describe gender, race, and age-related differences in the prevalence and prognostic significance of minor NSSTTA.

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“…Resting ECG signs of prior MI (ECG-MI; definite prior MI based on Minnesota code Q-waves12 or other criteria13 14) are precise, more objective and may have strong prognostic value 15. Despite this, ECG Q-waves as a sign of old MI are limited by several factors: (1) intra- and interobserver variability of ECG readers,16 17 (2) false positive and false negative Q-waves on resting ECG,18 Q-waves diminish or disappear in some patients after Q-wave MI,19–21 and (4) a trend towards a smaller proportion of MI presenting with ECG signs likely to result in permanent signs of MI on ECG in high-income nations 22–24. Nonetheless, given the numerous ECG survey studies conducted in low and middle-income regions from 1980 until the present (often without collecting self-reported history of MI) and the near or complete absence of ischaemic heart disease surveillance in these regions, we undertook this study in order to assess the validity of estimating prior MI prevalence based on ECG Q-waves alone.…”

Section: Introductionmentioning

confidence: 99%