SpringerLink
Log in

Gender modulates the aging effects on different patterns of early repolarization

  • Original Article
  • Published:
Heart and Vessels Aims and scope Submit manuscript

Abstract

Distinct patterns of early repolarization (ER) are associated with ventricular fibrillation and arrhythmic death. We evaluated whether gender modulated the aging effects on different ER patterns. We studied manifestations of ER in the anterior, inferior, and lateral leads on standard 12-lead electrocardiography from male (n = 1077) and female (n = 1170) individuals of young (≤44 years), middle-aged (45–64 years), and elderly (≥65 years) subjects. Among a total of 2247 individuals, 543 (24.2 %) subjects had ER and 417 (18.6 %) had single-location ER. Single-location ER occurred less in lateral leads than in anterior or inferior leads (2.1, 7.8, 8.6 %, respectively, p < 0.05). Subjects with inferior ER (n = 193) were older (61 ± 14, 49 ± 14, 54 ± 16 years, respectively, p < 0.05) than those with anterior (n = 176) or lateral (n = 48) ER. In males with ER, the elderly group (n = 22) had fewer instances of anterior ER (34, 59, 80 %, respectively, p < 0.05) than middle-aged (n = 76) or young (n = 59) groups. Elderly males (n = 37) and females (n = 48) had greater instances of inferior ER (57, 32, 19 %, p < 0.05; 86, 62, 46 %, respectively, p < 0.05) than middle-aged males (n = 41) and females (n = 41), and young males (n = 14) and females (n = 12), respectively. In conclusion, gender modulates the aging effects on the occurrences of anterior ER and inferior ER.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Wasserburger RH, Alt WJ (1961) The normal RS-T segment elevation variant. Am J Cardiol 8:184–192

    Article  CAS  PubMed  Google Scholar 

  2. Haïssaguerre M, Derval N, Sacher F, Jesel L, Deisenhofer I, de Roy L, Pasquié JL, Nogami A, Babuty D, Yli-Mayry S, De Chillou C, Scanu P, Mabo P, Matsuo S, Probst V, Le Scouarnec S, Defaye P, Schlaepfer J, Rostock T, Lacroix D, Lamaison D, Lavergne T, Aizawa Y, Englund A, Anselme F, O’Neill M, Hocini M, Lim KT, Knecht S, Veenhuyzen GD, Bordachar P, Chauvin M, Jais P, Coureau G, Chene G, Klein GJ, Clémenty J (2008) Sudden cardiac arrest associated with early repolarization. N Engl J Med 358:2016–2023

    Article  PubMed  Google Scholar 

  3. Nam GB, Kim YH, Antzelevitch C (2008) Augmentation of J waves and electrical storms in patients with early repolarization. N Engl J Med 358:2078–2079

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  4. Tikkanen JT, Anttonen O, Junttila MJ, Aro AL, Kerola T, Rissanen HA, Reunanen A, Huikuri HV (2009) Long-term outcome associated with early repolarization on electrocardiography. N Engl J Med 361:2529–2537

    Article  CAS  PubMed  Google Scholar 

  5. Merchant FM, Noseworthy PA, Weiner RB, Singh SM, Ruskin JN, Reddy VY (2009) Ability of terminal QRS notching to distinguish benign from malignant electrocardiographic forms of early repolarization. Am J Cardiol 104:1402–1406

    Article  PubMed  Google Scholar 

  6. Tikkanen JT, Junttila MJ, Anttonen O, Aro AL, Luttinen S, Kerola T, Sager SJ, Rissanen HA, Myerburg RJ, Reunanen A, Huikuri HV (2011) Early repolarization: electrocardiographic phenotypes associated with favorable long-term outcome. Circulation 14:2666–2673

    Article  Google Scholar 

  7. Junttila MJ, Sager SJ, Tikkanen JT, Anttonen O, Huikuri HV, Myerburg RJ (2012) Clinical significance of variants of J-points and J-waves: early repolarization patterns and risk. Eur Heart J 33:2639–2643

    Article  PubMed  Google Scholar 

  8. Bidoggia H, Maciel JP, Capalozza N, Mosca S, Blaksley EJ, Valverde E, Bertran G, Arini P, Biagetti MO, Quinteiro RA (2000) Sex-dependent electrocardiographic pattern of cardiac repolarization. Am Heart J 140:430–436

    Article  CAS  PubMed  Google Scholar 

  9. Surawicz B, Parikh SR (2002) Prevalence of male and female patterns of early ventricular repolarization in the normal ECG of males and females from childhood to old age. J Am Coll Cardiol 40:1870–1876

    Article  PubMed  Google Scholar 

  10. Odell WD (2001) Endocrinology of sexual maturation. In: De Groot LJ, Jameson JL (eds) Endocrinology, 4th edn. WB Saunders Co., Philadelphia, pp 1955–1960

    Google Scholar 

  11. Nankin HR, Calkins JH (1986) Decreased bioavailable testosterone in aging normal and impotent men. J Clin Endocrinol Metab 63:1418–1420

    Article  CAS  PubMed  Google Scholar 

  12. Ezaki K, Nakagawa M, Taniguchi Y, Nagano Y, Teshima Y, Yufu K, Takahashi N, Nomura T, Satoh F, Mimata H, Saikawa T (2010) Gender differences in the ST segment: effect of androgen-deprivation therapy and possible role of testosterone. Circ J 74:2448–2454

    Article  PubMed  Google Scholar 

  13. Liu G, Tamura A, Torigoe K, Kawano Y, Shinozaki K, Kotoku M, Kadota J (2012) Abnormal P-wave terminal force in lead V1 is associated with cardiac death or hospitalization for heart failure in prior myocardial infarction. Heart Vessels. doi:10.1007/s00380-012-0307-9

  14. Torigoe K, Tamura A, Kawano Y, Shinozaki K, Kotoku M, Kadota J (2012) Upright T waves in lead aVR are associated with cardiac death or hospitalization for heart failure in patients with a prior myocardial infarction. Heart Vessels 27:548–552

    Article  PubMed  Google Scholar 

  15. Antzelevitch C, Brugada P, Borggrefe M, Brugada J, Brugada R, Corrado D, Gussak I, LeMarec H, Nademanee K, Perez Riera AR, Shimizu W, Schulze-Bahr E, Tan H, Wilde A (2005) Brugada syndrome: report of the second consensus conference: endorsed by the Heart Rhythm Society and the European Heart Rhythm Association. Circulation 111:659–670

    Google Scholar 

  16. Antzelevitch C, Yan GX (2011) J-wave syndromes from cell to bedside. J Electrocardiol 44:656–661

    Article  PubMed Central  PubMed  Google Scholar 

  17. Bidoggia H, Maciel JP, Capalozza N, Mosca S, Blaksley EJ, Valverde E, Bertran G, Arini P, Biagetti MO, Quinteiro RA (2000) Sex differences on the electrocardiographic pattern of cardiac repolarization: possible role of testosterone. Am Heart J 140:678–683

    Article  CAS  PubMed  Google Scholar 

  18. Shimizu W, Matsuo K, Kokubo Y, Satomi K, Kurita T, Noda T, Nagaya N, Suyama K, Aihara N, Kamakura S, Inamoto N, Akahoshi M, Tomoike H (2007) Sex hormone and gender difference—role of testosterone on male predominance in Brugada syndrome. J Cardiovasc Electrophysiol 18:415–421

    Article  PubMed  Google Scholar 

  19. Matsuo K, Akahoshi M, Seto S, Yano KA (2003) Disappearance of the Brugada-type electrocardiogram after surgical castration: a role for testosterone and an explanation for the male preponderance. Pacing Clin Electrophysiol 26:1551–1553

    Article  PubMed  Google Scholar 

  20. Scragg JL, Jones RD, Channer KS, Jones TH, Peers C (2004) Testosterone is a potent inhibitor of L-type Ca2+ channels. Biochem Biophys Res Comm 318:503–506

    Article  CAS  PubMed  Google Scholar 

  21. Pham TV, Sosunov EA, Gainullin RZ, Danilo P Jr, Rosen MR (2004) Impact of sex and gonadal steroids on prolongation of ventricular repolarization and arrhythmias induced by IK-blocking drugs. Circulation 103:2207–2212

    Article  Google Scholar 

  22. Pham TV, Sosunov EA, Anyukhovsky EP, Danilo P Jr, Rosen MR (2002) Testosterone diminishes the proarrhythmic effects of dofetilide in normal female rabbits. Circulation 106:2132–2136

    Article  CAS  PubMed  Google Scholar 

  23. Morita H, Takenaka-Morita S, Fukushima-Kusano K, Kobayashi M, Nagase S, Kakishita M, Nakamura K, Emori T, Matsubara H, Ohe T (2003) Risk stratification for asymptomatic patients with Brugada syndrome. Circ J 67:312–316

    Article  PubMed  Google Scholar 

  24. Smetana P, Batchvarov VN, Hnatkova K, Camm AJ, Malik M (2002) Sex differences in repolarization homogeneity and its circadian pattern. Am J Physiol Heart Circ Physiol 282:H1889–H1897

    CAS  PubMed  Google Scholar 

  25. Rodriguez I, Kilborn MJ, Liu XK, Pezzullo JC, Woosley RL (2001) Drug-induced QT prolongation in women during the menstrual cycle. JAMA 285:1322–1326

    Article  CAS  PubMed  Google Scholar 

  26. Pewsner D, Jüni P, Egger M, Battaglia M, Sundström J, Bachmann LM (2007) Accuracy of electrocardiography in diagnosis of left ventricular hypertrophy in arterial hypertension: systematic review. BMJ 335:711

    Article  PubMed Central  PubMed  Google Scholar 

  27. Rudic B, Veltmann C, Kuntz E, Behnes M, Elmas E, Konrad T, Kuschyk J, Weiss C, Borggrefe M, Schimpf R (2012) Early repolarization pattern is associated with ventricular fibrillation in patients with acute myocardial infarction. Heart Rhythm 9:1295–1300

    Article  PubMed  Google Scholar 

  28. Patel RB, Ng J, Reddy V, Chokshi M, Parikh K, Subacius H, Alsheikh-Ali AA, Nguyen T, Link MS, Goldberger JJ, Ilkhanoff L, Kadish AH (2010) Early repolarization associated with ventricular arrhythmias in patients with chronic coronary artery disease. Circ Arrhythm Electrophysiol 3:489–495

    Article  PubMed  Google Scholar 

  29. Rosso R, Adler A, Halkin A, Viskin S (2011) Risk of sudden death among young individuals with J waves and early repolarization: putting the evidence into perspective. Heart Rhythm 8:923–929

    Article  PubMed  Google Scholar 

  30. Rollin A, Maury P, Bongard V, Sacher F, Delay M, Duparc A, Mondoly P, Carrié D, Ferrières J, Ruidavets JB (2012) Prevalence, prognosis, and identification of the malignant form of early repolarization pattern in a population-based study. Am J Cardiol 110:1302–1308

    Article  PubMed  Google Scholar 

  31. Guntekin U, Gumrukcuoglu HA, Gunes Y, Gunes A, Simsek H, Sahin M, Sezen Y, Akdağ S, Tuncer M (2011) The effects of perindopril on QT duration and dispersion in patients with coronary slow flow. Heart Vessels 26:357–362

    Article  PubMed  Google Scholar 

  32. Tereshchenko LG, McCabe A, Han L, Sur S, Huang T, Marine JE, Cheng A, Spragg DD, Sinha S, Calkins H, Stein K, Tomaselli GF, Berger RD (2012) Intracardiac J-point elevation before the onset of polymorphic ventricular tachycardia and ventricular fibrillation in patients with an implantable cardioverter-defibrillator. Heart Rhythm 9:1594–1602

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

The work was supported by the National Science Council of Taiwan [NSC99-2314-B-016-034-MY3, NSC99-2628-B-038-011-MY3, NSC100-2628-B-038-001-MY4, and NSC100-2314-B-038-027-MY3]; and Taipei Medical University-Wan Fang Hospital [101swf01 and 101-wf-eva-05]. The statistical method of this study was advised and revised by Dr. Yen-Kuang Lin Ph.D. from the Biostatistics and Research Consultation Center in Taipei Medical University.

Author information

Authors and Affiliations

  1. Division of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, 111 Hsin-Lung Road, Sec. 3, Taipei 116, Taipei, Taiwan

    Yen-Chou Chen, Jen-Hung Huang, Yung-Kuo Lin, Ming-Hsiung Hsieh & Yi-Jen Chen

  2. Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    Yi-Jen Chen

Authors
  1. Yen-Chou Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jen-Hung Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yung-Kuo Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ming-Hsiung Hsieh
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yi-Jen Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yi-Jen Chen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chen, YC., Huang, JH., Lin, YK. et al. Gender modulates the aging effects on different patterns of early repolarization. Heart Vessels 29, 249–255 (2014). https://doi.org/10.1007/s00380-013-0352-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00380-013-0352-z

Keywords

Search

Navigation