Medical Classification Centre, Central Manpower Base, Singapore Armed Forces, 3 Depot Road, Singapore 109680.
Europace. 2012 Jul;14(7):1018-24. doi: 10.1093/europace/eur424. Epub 2012 Feb 2.
Resting 12-lead electrocardiograms (ECGs) have been employed in the pre-participation evaluation of young asymptomatic subjects to detect pre-existing heart diseases. Although the incorporation of routine ECG in pre-participation screening remains controversial, there is increasing evidence that cardiomyopathies and ion channelopathies have ECG changes as the initial manifestation. The causes of sudden cardiac death in young people show significant geographical variation. We aim to determine the prevalence and spectrum of ECG abnormalities in a young male South-East Asian population.
The Singapore Armed Forces Electrocardiogram and Echocardiogram (SAFE) protocol is an ECG-based pre-participation cardiac screening programme modelled after the Italian system. From October 2008 to May 2009, a total of 18 476 young male conscripts (mean age 19.5 years old, range 16-27) underwent mandatory pre-enlistment medical screening at a single medical facility. Subjects with abnormal ECG findings were classified into two groups: Group A had ECG changes that fulfilled a pre-specified checklist to screen for hypertrophic cardiomyopathy and were referred for transthoracic echocardiogram; Group B had other ECG abnormalities [such as Brugada pattern, Wolff-Parkinson-White (WPW) pattern, long QTc] and were referred for secondary screening at a tertiary institution. Of the 18 476 subjects screened, 7.0% (n= 1285) had ECG abnormalities. Of note, 19 (0.10%) had Brugada pattern, 25 (0.14%) had WPW pattern, and 31 (0.17%) had prolonged QT interval on ECG. The prevalence of ECG abnormalities was significantly higher in Chinese than in South Asians (7.2 vs. 5.7%, P= 0.003).
The prevalence of ECG abnormalities in a young, South-East Asian male population was 7.0%. There were significant ethnic differences, with ECG abnormalities more prevalent in Chinese than in South Asians (7.2 vs. 5.7%, P= 0.003). The inclusion of universal ECG, in addition to history and physical examination, may increase the sensitivity of a cardiovascular screening programme. Knowledge of the spectrum and prevalence of ECG abnormalities and disease conditions would be pivotal in designing customized screening programmes.
静息 12 导联心电图（ECG）已用于无症状年轻受试者的参赛前评估，以检测潜在的心脏病。尽管将常规 ECG 纳入参赛前筛查仍存在争议，但越来越多的证据表明，心肌病和离子通道病的初始表现为 ECG 改变。年轻人心源性猝死的原因存在显著的地域差异。我们旨在确定东南亚年轻男性人群中 ECG 异常的发生率和范围。
新加坡武装部队心电图和超声心动图（SAFE）方案是一种基于 ECG 的参赛前心脏筛查计划，其模式借鉴了意大利系统。从 2008 年 10 月至 2009 年 5 月，共有 18476 名年轻男性应征者（平均年龄 19.5 岁，范围 16-27 岁）在一个医疗设施接受强制性入伍前医学筛查。心电图异常的受试者分为两组：A 组心电图改变符合肥厚型心肌病筛查的预定义清单，被转介进行经胸超声心动图检查；B 组有其他 ECG 异常[如 Brugada 模式、Wolff-Parkinson-White (WPW) 模式、长 QTc]，被转介到三级医疗机构进行二级筛查。在筛查的 18476 名受试者中，7.0%（n=1285）存在心电图异常。值得注意的是，19 例（0.10%）存在 Brugada 模式，25 例（0.14%）存在 WPW 模式，31 例（0.17%）存在心电图 QT 间期延长。与南亚人相比，中国人的心电图异常发生率显著更高（7.2%比 5.7%，P=0.003）。
东南亚年轻男性人群中心电图异常的发生率为 7.0%。存在显著的种族差异，中国人的心电图异常发生率高于南亚人（7.2%比 5.7%，P=0.003）。除了病史和体格检查外，普遍进行心电图检查可能会提高心血管筛查计划的敏感性。了解心电图异常和疾病的谱和流行率对于设计定制化的筛查计划至关重要。
