Frequent coexistence of early repolarization pattern, J‐point elevation, and high Sokolow‐Lyon voltage in young men

• Published in: Journal of arrhythmia Vol. 39; no. 1; pp. 61 - 70
• Main Authors: Saito, Nagomi, Nagahara, Daigo, Kamiyama, Naoyuki, Fujito, Takefumi, Koyama, Masayuki, Mochizuki, Atsushi, Yano, Toshiyuki, Takahashi, Satoshi
• Format: Journal Article
• Language: English
• Published: Japan John Wiley & Sons, Inc 01.02.2023; John Wiley and Sons Inc; Wiley
• Subjects: Age groups; androgen; Androgens; Cardiovascular disease; early repolarization; Electrocardiogram; Electrocardiography; Gender; Heart rate; J wave; Males; Original; Puberty; Sinuses; Sokolow‐Lyon voltage; Teenagers; Women; Youth; androgen; electrocardiogram; Sokolow‐Lyon voltage; J wave; early repolarization
• ISSN: 1880-4276; 1883-2148
• DOI: 10.1002/joa3.12813

Background 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. Methods 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. Results In early teenagers, there was no significant gender difference in the prevalence of an ER pattern (24% in men vs. 28% in women, p = .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. Conclusion 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. Earlier studies have shown male dominance of an early repolarization pattern and frequent coexistence with high Sokolow‐Lyon voltage, but the mechanism has not been clarified yet. The male dominance of 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.