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Impact of Ethnicity on the Prevalence of Early Repolarization Pattern in Children: Comparison Between Caucasian and African Populations

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Abstract

The patterns and prevalence of early repolarization pattern (ER) in pediatric populations from ethnic backgrounds other than Caucasian have not been determined. Black African children (ages 4–12) from north-west Madagascar were prospectively recruited and their ECGs compared with those of age- and sex-matched Caucasian ethnicity individuals. ER was defined by ≥ 0.1 mV J-point elevation in at least two contiguous inferior and/or lateral ECG leads. A total of 616 children were included. There was a trend toward a higher frequency of ER in the Africans compared to the Caucasians (23.3% vs. 17.1%, respectively, p = 0.053). The subtype (slurred vs. notched) and location of ER (lateral, inferior, or inferior-lateral) were significantly different in the two groups (p < 0.001 and p = 0.020, respectively). There was no significant difference in the number of high-risk ECG features of ERP (i.e., horizontal/descendent pattern, inferior or inferior-lateral location or J-waves ≥ 2 mm) between African and Caucasian children. On the multivariate analysis, African ethnicity was an independent predictive factor of ER (OR 3.57, 95% CI 2.04–6.25, p < 0.001). African children have an increased risk of ER compared to Caucasian counterparts. Future studies should clarify the clinical and prognostic significance of ER in the pediatric population, and whether ethnicity has an impact on the outcomes.

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Authors and Affiliations

  1. Barts Heart Centre, St. Bartholomew’s Hospital, West Smithfield, London, EC1A7BE, UK

    Antonio Creta, Pier D. Lambiase & Rui Providência

  2. Campus Bio-Medico University of Rome, Rome, Italy

    Antonio Creta, Davide Costanzo, Stefano Di Berardino, Umberto Satriano & Giovanni Mottini

  3. Division of Pediatrics, Department of Medicine, University Hospital of Udine, Udine, Italy

    Michele Arigliani & Paola Cogo

  4. Unit of Cardiology, Campus Bio-Medico University of Rome, Rome, Italy

    Giuseppe di Gioia

  5. Hospital of Sant’Antonio, San Daniele del Friuli, Italy

    Roberta Lapenna

  6. Unit of Pediatrics, Campus Bio-Medico University of Rome, Rome, Italy

    Fabio Quintarelli

  7. Department of Paediatric Cardiology, Paediatric Cardiothoracic Surgery, Great Ormond Street Hospital for Children’s NHS Trust, London, United Kingdom

    Mario Fittipaldi

  8. Unit of Anaesthesia, Intensive Care and Pain Management, Campus Bio-Medico University of Rome, Rome, Italy

    Vincenzo Antinolfi

  9. Cardiothoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy

    Ranieri Bettini

  10. Unit of Neurology, Campus Bio-Medico University of Rome, Rome, Italy

    Alessandro Cruciani

  11. Unit of Endocrinology and Diabetes, Campus Bio-Medico University of Rome, Rome, Italy

    Riccardo Giorgino

  12. Department of Thoracic Surgery and Lung Transplantation, Paris Descartes University, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, Paris, France

    Giuseppe Mangiameli

  13. Cardiothoracic Department, Division of Cardiology, University Hospital of Udine, Udine, Italy

    Dario Sut & Alessandro Proclemer

  14. Geriatric Surgery Unit, Campus Bio-Medico University of Rome, Rome, Italy

    Marco Caricato

Authors
  1. Antonio Creta
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  2. Michele Arigliani
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  3. Giuseppe di Gioia
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  4. Roberta Lapenna
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  5. Fabio Quintarelli
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  6. Mario Fittipaldi
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  7. Vincenzo Antinolfi
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  8. Ranieri Bettini
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  9. Davide Costanzo
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  10. Alessandro Cruciani
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  11. Stefano Di Berardino
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  12. Riccardo Giorgino
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  14. Giuseppe Mangiameli
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  15. Dario Sut
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  16. Marco Caricato
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  17. Paola Cogo
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  19. Giovanni Mottini
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  20. Pier D. Lambiase
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  21. Rui Providência
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Contributions

AC designed and directed this study, drafted the manuscript, and participated in data collection, analysis and interpretation. MA participated in data collection and interpretation, and critically revised the manuscript. RL participated in data collection, analysis, and interpretation. FQ and GDG participated in data collection, and analysis. MF, VA, RB, DC, ACru, SDB, RG, US, GM, DS, MC, and GM participated in data collection. RP performed statistics and critically revised the article. PDL, PC, and AP critically revised the manuscript. All the authors approved the final version of the manuscript.

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Correspondence to Antonio Creta.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Creta, A., Arigliani, M., di Gioia, G. et al. Impact of Ethnicity on the Prevalence of Early Repolarization Pattern in Children: Comparison Between Caucasian and African Populations. Pediatr Cardiol 40, 1553–1558 (2019). https://doi.org/10.1007/s00246-019-02185-1

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