Nonanterior early repolarization pattern was present in 25.1% of athletes and associated with black race (OR 5.84; 95% CI 3.54-9.61; P<0.001), increased QRS voltage, and slower heart rate.
Cross-Sectional (n=879)
Does intense physical training affect the prevalence of early repolarization pattern in competitive athletes?
Nonanterior early repolarization pattern is common in competitive athletes, strongly associated with black race, increased QRS voltage, and slower heart rate, and its prevalence increases with intense physical training.
Effect estimate: OR 5.84 (95% CI 3.54 to 9.61)
p-value: p=< 0.001
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.
Noseworthy et al. (Thu,) conducted a cross-sectional in Early repolarization pattern (n=879). Exercise training vs. Baseline (before training) was evaluated on Association of early repolarization pattern with black race (OR 5.84, 95% CI 3.54 to 9.61, p=< 0.001). Nonanterior early repolarization pattern was present in 25.1% of athletes and associated with black race (OR 5.84; 95% CI 3.54-9.61; P<0.001), increased QRS voltage, and slower heart rate.