Objective: Early
repolarization pattern (ER) on surface ECG has recently been associated with an
increased risk of sudden cardiac death (SCD) due to lethal ventricular
arrhythmias. Inflammatory markers such as high-sensitive-C-reactive peptide
(hs-CRP) have been linked with an increased risk of SCD and cardiac morbidity
in numerous publications for various cardiovascular settings. However, data
about the relationship between the inflammatory markers and ER is scarce. We
sought to evaluate the relationship of subclinical inflammatory markers and the
presence of ER on healthy Turkish males.
Materials and Methods: 180 healthy male volunteers between ≥18 to ≤50 years old without any
cardiac/systemic disorders were evaluated for our study. Supine surface ECG,
complete blood count, hs-CRP, Erythrocyte sedimentation rate (ESR) and serum
electrolytes were obtained. Subjects with complete-bundle-branch-blocks,
non-sinus-rhythms and any abnormality on cardiac examination were excluded. ER
was defined as J-point elevation of ≥0.1 mV in ≥2 leads in the inferior (II,
III, aVF) (Inferior ER), lateral (DI, aVL, V4–6) (Lateral ER) or both
(Inferolateral ER) leads.
Results: 172 subjects (mean age 34,9±7,9 years) were included
in our analyses. 45 ER (26%) was detected. 22 of them were lateral (49%), 13
was inferior (29%) and 10 of them were (22%) inferolateral ER. ER+ subjects had
significantly higher hs-CRP levels (mg/dl, mean±SD) (ER- 1.7±1.8 vs ER+ 3.1±2.9, p<0.01). No significant association could be
demonstrated with other inflammatory parameters. In the subgroup analyses, only
inferior ER was significantly associated with higher hs-CRP levels compared
with the ER - population, while hs-CRP levels of subjects with lateral and
infero-lateral ER was not significantly higher (ER- 1.7±1.8
vs Inferior ER 4.5
± 3.1, p<0,01). In
multivariate analyses, high hs-CRP levels were significantly predicting the
presence of ER (Odds ratio: 1,24; %95 CI: 1,06 - 1,46; p = 0,008).
Conclusions:
Subclinical inflammation might influence the
prevalence of ER on young healthy males. Suggestively more malignant Inferior
ER seems to be mainly associated with the high hs-CRP levels in Turkish male
population. This finding might be attributed to the experimentally demonstrated
effects of inflammation on various cardiac ion channel functions taking part in
the cardiac action potential.
c-reactive peptide complete blood count early repolarization pattern electrocardiogram male
Primary Language | English |
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Subjects | Health Care Administration |
Journal Section | Medical Science Research Articles |
Authors | |
Publication Date | March 28, 2019 |
Acceptance Date | March 25, 2019 |
Published in Issue | Year 2019Volume: 41 Issue: 1 |