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Pediatric Cardiology

, Volume 40, Issue 8, pp 1553–1558 | Cite as

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

  • Antonio CretaEmail author
  • Michele Arigliani
  • Giuseppe di Gioia
  • Roberta Lapenna
  • Fabio Quintarelli
  • Mario Fittipaldi
  • Vincenzo Antinolfi
  • Ranieri Bettini
  • Davide Costanzo
  • Alessandro Cruciani
  • Stefano Di Berardino
  • Riccardo Giorgino
  • Umberto Satriano
  • Giuseppe Mangiameli
  • Dario Sut
  • Marco Caricato
  • Paola Cogo
  • Alessandro Proclemer
  • Giovanni Mottini
  • Pier D. Lambiase
  • Rui Providência
Original Article

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.

Keywords

Early repolarization Ethnicity Sudden death Pediatrics 

Notes

Author 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.

Compliance with Ethical Standards

Conflict of interest

Authors have no conflicts of interest to declare.

Ethical Approval

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.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Antonio Creta
    • 1
    • 2
    Email author
  • Michele Arigliani
    • 3
  • Giuseppe di Gioia
    • 4
  • Roberta Lapenna
    • 5
  • Fabio Quintarelli
    • 6
  • Mario Fittipaldi
    • 7
  • Vincenzo Antinolfi
    • 8
  • Ranieri Bettini
    • 9
  • Davide Costanzo
    • 2
  • Alessandro Cruciani
    • 10
  • Stefano Di Berardino
    • 2
  • Riccardo Giorgino
    • 11
  • Umberto Satriano
    • 2
  • Giuseppe Mangiameli
    • 12
  • Dario Sut
    • 13
  • Marco Caricato
    • 14
  • Paola Cogo
    • 3
  • Alessandro Proclemer
    • 13
  • Giovanni Mottini
    • 2
  • Pier D. Lambiase
    • 1
  • Rui Providência
    • 1
  1. 1.Barts Heart CentreSt. Bartholomew’s HospitalLondonUK
  2. 2.Campus Bio-Medico University of RomeRomeItaly
  3. 3.Division of Pediatrics, Department of MedicineUniversity Hospital of UdineUdineItaly
  4. 4.Unit of CardiologyCampus Bio-Medico University of RomeRomeItaly
  5. 5.Hospital of Sant’AntonioSan Daniele del FriuliItaly
  6. 6.Unit of PediatricsCampus Bio-Medico University of RomeRomeItaly
  7. 7.Department of Paediatric Cardiology, Paediatric Cardiothoracic SurgeryGreat Ormond Street Hospital for Children’s NHS TrustLondonUnited Kingdom
  8. 8.Unit of Anaesthesia, Intensive Care and Pain ManagementCampus Bio-Medico University of RomeRomeItaly
  9. 9.Cardiothoracic and Vascular DepartmentUniversity Hospital of PisaPisaItaly
  10. 10.Unit of NeurologyCampus Bio-Medico University of RomeRomeItaly
  11. 11.Unit of Endocrinology and DiabetesCampus Bio-Medico University of RomeRomeItaly
  12. 12.Department of Thoracic Surgery and Lung TransplantationParis Descartes University, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de ParisParisFrance
  13. 13.Cardiothoracic Department, Division of CardiologyUniversity Hospital of UdineUdineItaly
  14. 14.Geriatric Surgery UnitCampus Bio-Medico University of RomeRomeItaly

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