Klatsky Arthur L, Oehm Rudolph, Cooper Robert A, Udaltsova Natalia, Armstrong Mary Anne
Department of Medicine, Kaiser Permanente Medical Care Program, Oakland, California 94611, USA.
Am J Med. 2003 Aug 15;115(3):171-7. doi: 10.1016/s0002-9343(03)00355-3.
We compared the characteristics and outcomes of patients with "early repolarization" electrocardiograms (ECGs) with those who had normal ECGs.
In 1983 to 1985, we collected photocopies of 2234 selected ECGs from 73088 patients undergoing health examinations. Excluding 153 ECGs with missing data or that were judged to be abnormal, the remaining ECGs were reinterpreted in 2000 by cardiologists as showing early repolarization (n = 670), or being borderline (n = 330) or normal (n = 1081). Characteristics and outcomes of persons with early repolarization ECGs were compared with those who had normal ECGs using analysis of variance, logistic regression, or proportional hazards models. Information on exercise was available in 325 patients.
Patients with early repolarization were more likely to be male (81% [n = 583] vs. 33% [n = 360]), <40 years old (60% [n = 441] vs. 37% [n = 403]), black (48% [n = 384] vs. 26% [n = 280]), and more athletically active (mean [+/- SD], 10.4 +/- 1.3 hours per week of activity vs. 6.4 +/- 1.2 hours per week of activity) than those with normal ECGs. Patients with early repolarization were not more likely to be hospitalized (hazard ratio [HR] = 1.0; 95% confidence interval [CI]: 0.9 to 1.2) or to die (HR = 0.8; 95% CI: 0.6 to 1.2) during follow-up than those with normal ECGs. Outpatient diagnoses were not more common in those with early repolarization; arrhythmias were actually less common (P <0.01).
Although especially prevalent in young, athletic, black men, early repolarization is not rare in other patients. The long-term prognosis of early repolarization is benign.
我们比较了心电图（ECG）表现为“早期复极”的患者与心电图正常患者的特征及预后。
1983年至1985年，我们从73088例接受健康检查的患者中收集了2234份选定心电图的复印件。排除153份数据缺失或被判定为异常的心电图后，其余心电图在2000年由心脏病专家重新解读，结果显示为早期复极（n = 670）、临界状态（n = 330）或正常（n = 1081）。采用方差分析、逻辑回归或比例风险模型，比较早期复极心电图患者与正常心电图患者的特征及预后。325例患者有运动相关信息。
与心电图正常的患者相比，早期复极患者更可能为男性（81% [n = 583] 对33% [n = 360]）、年龄小于40岁（60% [n = 441] 对37% [n = 403]）、黑人（48% [n = 384] 对26% [n = 280]），且运动更活跃（平均[±标准差]，每周活动10.4 ± 1.3小时对每周活动6.4 ± 1.2小时）。在随访期间，早期复极患者住院（风险比[HR] = 1.0；95%置信区间[CI]：0.9至1.2）或死亡（HR = 0.8；95% CI：0.6至1.2）的可能性并不高于心电图正常的患者。门诊诊断在早期复极患者中并不更常见；心律失常实际上更少见（P <0.01）。
尽管早期复极在年轻、爱运动的黑人男性中尤为普遍，但在其他患者中也并不罕见。早期复极的长期预后良好。
