The early repolarization pattern in the general population: Clinical correlates and heritability

Peter A. Noseworthy, Jani T. Tikkanen, Kimmo Porthan, Lasse Oikarinen, Arto Pietil, Kennet Harald, Gina M. Peloso, Faisal M. Merchant, Antti Jula, Heikki Vnnen, Shih Jen Hwang, Christopher J. O'Donnell, Veikko Salomaa, Christopher Newton-Cheh, Heikki V. Huikuri

Research output: Contribution to journalArticlepeer-review

148 Scopus citations


Objectives: This study sought to describe the clinical correlates and heritability of the early repolarization pattern (ERP) in 2 large, population-based cohorts. Background: There is growing recognition that ERP is associated with adverse outcomes. Methods: Participants of the Framingham Heart Study (FHS) (N = 3,995) and the Health 2000 Survey (H2K) (N = 5,489) were included. ERP was defined as a J-point elevation <0.1 mV in <2 leads in either the inferior (II, III, aVF) or lateral (I, aVL, V46) territory or both. We tested the association between clinical characteristics and ERP, and estimated sibling recurrence risk. Results: ERP was present in 243 of 3,955 (6.1%) of FHS and 180 of 5,489 (3.3%) of H2K subjects. Male sex, younger age, lower systolic blood pressure, higher Sokolow-Lyon index, and lower Cornell voltage were independently associated with the presence of ERP. In the FHS sample, siblings of individuals with ERP had an ERP prevalence of 11.6% (recurrence risk ratio of 1.89). Siblings of individuals with ERP had an increased unadjusted odds of ERP (odds ratio: 2.22, 95% confidence interval: 1.01 to 4.85, p = 0.047). Conclusions: ERP has strong association with clinical factors and has evidence for a heritable basis in the general population. Further assessment of the genetic determinants of ERP is warranted.

Original languageEnglish (US)
Pages (from-to)2284-2289
Number of pages6
JournalJournal of the American College of Cardiology
Issue number22
StatePublished - May 31 2011


  • ECG
  • early repolarization
  • heritability

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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