Saito Nagomi, Nagahara Daigo, Kamiyama Naoyuki, Fujito Takefumi, Koyama Masayuki, Mochizuki Atsushi, Yano Toshiyuki, Takahashi Satoshi
Division of Laboratory Medicine Sapporo Medical University Hospital Sapporo Japan.
Department of Cardiology Teine Keijinkai Hospital Sapporo Japan.
J Arrhythm. 2023 Jan 9;39(1):61-70. doi: 10.1002/joa3.12813. eCollection 2023 Feb.
Earlier studies have shown male dominance of an early repolarization (ER) pattern and frequent coexistence with high Sokolow-Lyon voltage. Although possible involvement of androgen is speculated, the underlying mechanism has not been clarified yet. Previous studies were conducted in adult populations or only in children, and there has been no study in which the ER pattern was investigated in a series of individuals ranging from children before puberty to adults.
We included 600 individuals comprising six groups according to age: 10-14 years old, 15-19 years old, twenties, thirties, forties, and fifties. Each group had 50 males and 50 females. The distribution of an ER pattern and related ECG parameters were assessed by age and gender.
In early teenagers, there was no significant gender difference in the prevalence of an ER pattern (24% in men vs. 28% in women, = .82). The prevalence of an ER pattern increased after puberty and reached a peak in men in their twenties (42%). With further advance of age, the prevalence of an ER pattern decreased. On the other hand, the prevalence of an ER pattern in women peaked at 28% in teenagers, and it decreased through twenties (20%) to thirties (10%). Similar male dominance after puberty was observed in Sokolow-Lyon voltage and J-point elevation but not in P-wave amplitude.
The prevalence of an ER pattern, Sokolow-Lyon voltage, and J-point elevation are all augmented after puberty and decrease with aging, leading to frequent coexistence of these ECG findings in young men.
早期研究表明，早期复极（ER）模式存在男性优势，且常与高索科洛夫-里昂电压同时出现。尽管推测雄激素可能参与其中，但其潜在机制尚未阐明。以往研究是在成年人群中进行的，或者仅针对儿童，尚无研究对从青春期前儿童到成年人的一系列个体的ER模式进行调查。
我们纳入了600名个体，根据年龄分为六组：10 - 14岁、15 - 19岁、二十多岁、三十多岁、四十多岁和五十多岁。每组有50名男性和50名女性。通过年龄和性别评估ER模式及相关心电图参数的分布情况。
在青少年早期，ER模式的患病率在性别上无显著差异（男性为24%，女性为28%，P = 0.82）。ER模式的患病率在青春期后增加，在二十多岁的男性中达到峰值（42%）。随着年龄进一步增长，ER模式的患病率下降。另一方面，女性中ER模式的患病率在青少年时期达到峰值28%，在二十多岁时降至20%，三十多岁时降至10%。在索科洛夫-里昂电压和J点抬高方面，青春期后也观察到类似的男性优势，但在P波振幅方面未观察到。
ER模式、索科洛夫-里昂电压和J点抬高的患病率在青春期后均升高，并随年龄增长而下降，导致这些心电图表现常同时出现在年轻男性中。
