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Long ‐ Term Prognosis of Brugada ‐ Type ECG and ECG With Atypical ST ‐ Segment Elevation in the Right Precordial Leads Over 20   Years: Results From the Circulatory Risk in Communities Study ( CIRCS )

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ABSTRACT

Background: Brugada syndrome is recognized as being associated with sudden cardiac death; however, the prevalence of non–type 1 Brugada‐type ECG (BrS) or atypical ST‐segment elevation in the right precordial leads (STERP) and the long‐term prognosis for those patients remain unknown.

Methods and results: We analyzed standard 12‐lead ECGs of 7178 apparently healthy participants (age range 40–64 years) who underwent health checkups from 1982 to 1986 in the Circulatory Risk in Communities Study, a prospective, large, community‐based cohort study in Japan. ECGs with J point amplitude ≥0.2 mV in the right precordial leads were divided into 3 groups: (1) type 1 BrS, (2) type 2 or 3 BrS (non‐type 1 BrS), and (3) STERP. The others served as the non–ST‐segment elevation group. We identified 8 participants (0.1%) with type1 BrS, 84 (1.2%) with non–type 1 BrS, and 228 (3.2%) with STERP. During a median follow‐up of 18.7 years (133 987.0 person‐years), sudden cardiac death was observed in no participants (0.0%) with type 1 BrS, in 1 (1.2%) with non–type 1 BrS, in 7 (3.1%) with STERP, and in 50 (0.7%) with non–ST‐segment elevation. Participants with STERP had a markedly elevated risk of sudden cardiac death (multivariable hazard ratio 3.9, 95% CI 1.7–9.0).

Conclusions: STERP was associated with an elevated risk of sudden cardiac death in a middle‐aged population.

No MeSH data available.


Flowchart of the entry process for the 7178 participants.
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jah31680-fig-0001: Flowchart of the entry process for the 7178 participants.

Mentions: The study included community residents aged 40 to 64 years who enrolled in a community‐based cohort of the Circulatory Risk in Community Study (CIRCS). CIRCS is a prospective community‐based study that was launched to examine risk factors of cardiovascular disease from 1963 onward and that is conducted by a research team from Osaka Medical Center for Health Science and Promotion, Osaka University, and the University of Tsukuba. The CIRCS participants lived in Ikawa town, Akita Prefecture (a northeastern rural community); Kyowa town, Ibaraki Prefecture (a central rural community); and Yao City, Osaka Prefecture (a southwestern suburb). Among them, we recruited 10 337 participants (4223 men, 6114 women) who underwent a health checkup from 1982 to 1986. We excluded 3159 participants who met the following exclusion criteria: age <40 or >64 years, no previous ECGs on record, and a past history of myocardial infarction and/or atrial fibrillation at registration (Figure 1). Systematic community surveillance of SCD was done for 7178 people (2886 men, 4292 women) who constituted the participants of this study. The population numbers in each community were 1780 in Ikawa (779 men, 1001 women), 3343 in Kyowa (1431 men, 1912 women), and 2055 in Yao (676 men, 1379 women). Informed consent was not obtained from the participants but was obtained from the community representatives to conduct an epidemiological study based on the guidelines of the Council for International Organizations of Medical Science. The study was approved by the ethics committees of Ibaraki Prefecture, University of Tsukuba, Osaka University, and Osaka Medical Center for Health Science and Promotion.


Long ‐ Term Prognosis of Brugada ‐ Type ECG and ECG With Atypical ST ‐ Segment Elevation in the Right Precordial Leads Over 20   Years: Results From the Circulatory Risk in Communities Study ( CIRCS )
Flowchart of the entry process for the 7178 participants.
© Copyright Policy - creativeCommonsBy-nc
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5015268&req=5

jah31680-fig-0001: Flowchart of the entry process for the 7178 participants.
Mentions: The study included community residents aged 40 to 64 years who enrolled in a community‐based cohort of the Circulatory Risk in Community Study (CIRCS). CIRCS is a prospective community‐based study that was launched to examine risk factors of cardiovascular disease from 1963 onward and that is conducted by a research team from Osaka Medical Center for Health Science and Promotion, Osaka University, and the University of Tsukuba. The CIRCS participants lived in Ikawa town, Akita Prefecture (a northeastern rural community); Kyowa town, Ibaraki Prefecture (a central rural community); and Yao City, Osaka Prefecture (a southwestern suburb). Among them, we recruited 10 337 participants (4223 men, 6114 women) who underwent a health checkup from 1982 to 1986. We excluded 3159 participants who met the following exclusion criteria: age <40 or >64 years, no previous ECGs on record, and a past history of myocardial infarction and/or atrial fibrillation at registration (Figure 1). Systematic community surveillance of SCD was done for 7178 people (2886 men, 4292 women) who constituted the participants of this study. The population numbers in each community were 1780 in Ikawa (779 men, 1001 women), 3343 in Kyowa (1431 men, 1912 women), and 2055 in Yao (676 men, 1379 women). Informed consent was not obtained from the participants but was obtained from the community representatives to conduct an epidemiological study based on the guidelines of the Council for International Organizations of Medical Science. The study was approved by the ethics committees of Ibaraki Prefecture, University of Tsukuba, Osaka University, and Osaka Medical Center for Health Science and Promotion.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Brugada syndrome is recognized as being associated with sudden cardiac death; however, the prevalence of non&ndash;type 1 Brugada&#8208;type ECG (BrS) or atypical ST&#8208;segment elevation in the right precordial leads (STERP) and the long&#8208;term prognosis for those patients remain unknown.

Methods and results: We analyzed standard 12&#8208;lead ECGs of 7178 apparently healthy participants (age range 40&ndash;64&nbsp;years) who underwent health checkups from 1982 to 1986 in the Circulatory Risk in Communities Study, a prospective, large, community&#8208;based cohort study in Japan. ECGs with J point amplitude &ge;0.2&nbsp;mV in the right precordial leads were divided into 3 groups: (1) type 1 BrS, (2) type 2 or 3 BrS (non&#8208;type 1 BrS), and (3) STERP. The others served as the non&ndash;ST&#8208;segment elevation group. We identified 8 participants (0.1%) with type1 BrS, 84 (1.2%) with non&ndash;type 1 BrS, and 228 (3.2%) with STERP. During a median follow&#8208;up of 18.7&nbsp;years (133 987.0&nbsp;person&#8208;years), sudden cardiac death was observed in no participants (0.0%) with type 1 BrS, in 1 (1.2%) with non&ndash;type 1 BrS, in 7 (3.1%) with STERP, and in 50 (0.7%) with non&ndash;ST&#8208;segment elevation. Participants with STERP had a markedly elevated risk of sudden cardiac death (multivariable hazard ratio 3.9, 95% CI 1.7&ndash;9.0).

Conclusions: STERP was associated with an elevated risk of sudden cardiac death in a middle&#8208;aged population.

No MeSH data available.