ClinicalGeneticDistinguishing “benign” from “malignant early repolarization”: The value of the ST-segment morphology
Section snippets
Methods
Our study population was recently described in detail.13 It consisted of 45 patients with idiopathic VF (aged 14–69 years, mean age 38 ± 15 years; 71% males), a “matched-control group” consisting of 124 healthy individuals matched by age and gender to the idiopathic VF patients, and an “athletes group” of 121 noncompetitive athletes (aged 17–19 years, 50% males) from a preparticipation medical screening program. “J-point elevation” or “J waves” were defined as positive “humplike” deflections
Results
As previously reported,13 J waves were more prevalent among patients with idiopathic VF than among age- and gender-matched controls (42% vs 13%; P <.001) or among young athletes (42% vs 22%; P = .013). J waves were more prevalent among males, and this was true for idiopathic VF patients as well as for controls (Table 1). However, once J waves were present, gender had no statistically significant effect on the contour of the ST segment (Table 1) and the only characteristic associated with J
Discussion
Early repolarization is a common ECG finding, with a prevalence ranging from 6% to 24% in population-based studies.16, 17, 18, 19 Moreover, series including 1000 athletes or more report that as many as 40% of healthy athletes have early repolarization.21 On the other hand, this finding has been strongly associated with idiopathic VF,12, 13, 14, 15, 25 a rare but highly lethal disease.26 Therefore, diagnostic tools capable of distinguishing the very common “benign early repolarization” from the
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Raphael Rosso and Eran Glikson contributed equally to this manuscript.