Pentti M Rautaharju1, Zhu-Ming Zhang2, Wesley K Haisty3, Richard E Gregg4, James Warren5, Milan B Horaĉek5, Anna M Kucharska-Newton6, Wayne Rosamond6, Elsayed Z Soliman7. 1. Epidemiological Cardiology Research Center (EPICARE), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC. Electronic address: pentti.rautaharju@gmail.com. 2. Epidemiological Cardiology Research Center (EPICARE), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC. 3. Department of Medicine, Section on Cardiology, Wake Forest School of Medicine, Winston Salem, NC. 4. Advanced Algorithms Research Center, Philips Healthcare, Andover, MA. 5. Dalhousie University, Halifax, NS, Canada. 6. Department of Epidemiology and Community Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC. 7. Epidemiological Cardiology Research Center (EPICARE), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC; Department of Medicine, Section on Cardiology, Wake Forest School of Medicine, Winston Salem, NC.
Abstract
BACKGROUND: Data are limited about race-and sex-associated differences in prognostically important ECG measures of regional repolarization. METHODS AND RESULTS: The normal reference group from the Atherosclerosis Risk in Communities (ARIC) study included 8,676 white and African-American men and women aged 40-65 years. Exclusion criteria included cardiovascular disease, hypertension, diabetes and major ECG abnormalities. Notable sex differences (p<0.001) were observed in the upper 98% limits for rate-adjusted QTend (QTea) which was 435 ms in white and African-American men and 445 ms in white and African-American women, and for left ventricular epicardial repolarization time (RTepi) which was 345 ms in white and African-American men and 465 ms in white and African-American women. These sex differences reflect earlier onset and end of repolarization in men than in women. Upper normal limits for STJ amplitude in V2-V3 were 100 μV in white and African-American women, 150 μV in white men and 200 μV in African-American men (p<0.001 for sex differences), and for other chest leads, aVL and aVF 50 μV in white women, 100 μV in African-American women, 100 μV in white men and 150 μV in African-American men (p<0.001 for sex and race differences). CONCLUSIONS: Shorter QTea and RTepi in men than in women reflect earlier onset and end of repolarization in men. STJ amplitudes in African-American men were higher than in other subgroups by race and sex. These sex and race differences need to be considered in clinical and epidemiological applications of normal standards.
BACKGROUND: Data are limited about race-and sex-associated differences in prognostically important ECG measures of regional repolarization. METHODS AND RESULTS: The normal reference group from the Atherosclerosis Risk in Communities (ARIC) study included 8,676 white and African-American men and women aged 40-65 years. Exclusion criteria included cardiovascular disease, hypertension, diabetes and major ECG abnormalities. Notable sex differences (p<0.001) were observed in the upper 98% limits for rate-adjusted QTend (QTea) which was 435 ms in white and African-American men and 445 ms in white and African-American women, and for left ventricular epicardial repolarization time (RTepi) which was 345 ms in white and African-American men and 465 ms in white and African-American women. These sex differences reflect earlier onset and end of repolarization in men than in women. Upper normal limits for STJ amplitude in V2-V3 were 100 μV in white and African-American women, 150 μV in white men and 200 μV in African-American men (p<0.001 for sex differences), and for other chest leads, aVL and aVF 50 μV in white women, 100 μV in African-American women, 100 μV in white men and 150 μV in African-American men (p<0.001 for sex and race differences). CONCLUSIONS: Shorter QTea and RTepi in men than in women reflect earlier onset and end of repolarization in men. STJ amplitudes in African-American men were higher than in other subgroups by race and sex. These sex and race differences need to be considered in clinical and epidemiological applications of normal standards.
Authors: C Cato Ter Haar; Jan A Kors; Ron J G Peters; Michael W T Tanck; Marieke B Snijder; Arie C Maan; Cees A Swenne; Bert-Jan H van den Born; Jonas S S G de Jong; Peter W Macfarlane; Pieter G Postema Journal: J Am Heart Assoc Date: 2020-06-23 Impact factor: 5.501
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