Comparison of electrocardiographic findings between Northern and Southern Chinese population samples

Major and minor ECG abnormalities depending on regional living conditions in Russia

The goal of our study was to explore the effect of living conditions on the odd of major and minor ECG abnormalities on a large region scale in Russia. For the analysis, cross-sectional data of the Russian study, ESSE-RF 2013-2014, were used. They were collected on a sample of 16,400 subjects from 10 regions of the Russia. ECG abnormalities were grouped into two categories: Major and Minor (sensu the 2009 version of the Minnesota Code Classification System). Regional living conditions were considered comprehensively via five indices combining 33 characteristics of the regions. The estimates were presented as odds ratios and their 95% confidence intervals. The prevalence values of major abnormalities in the sample were 8.4% among women and 9.4% among men (p = 0.021). The prevalence of minor abnormalities constituted 34.1% and 45.9%, respectively (p < 0.001). In men, the odd of major ECG abnormalities increased with the demographic depression growth (1.08: 1.04-1.12) and with industrial development growth in the region (1.12: 1.07-1.17). In women, an increase in the odd of major ECG abnormalities was directly associated with industrial development (1.12: 1.07-1.16) and inversely related to the economic development in the region (0.94: 0.89-0.99). The odd of minor ECG abnormalities in men and women declined with the growth of the regional economic development: OR of 0.95: 0.93-0.98, and OR of 0.92: 0.87-0.99, respectively. The study demonstrated an effect of regional living conditions of the Russian population on the odd of major and minor ECG abnormalities. The most stable and logically explainable relationships were obtained for industrial and economic characteristics of living conditions.

Prevalence of abnormal and borderline electrocardiogram changes in 13, 079 Chinese amateur marathon runners

BACKGROUND

The 12-lead electrocardiogram (ECG) has been adopted as an important component of preparticipation cardiovascular screening. However, there are still controversies in the screening and few studies with a large sample size have reported the results of ECGs of marathon runners. Therefore, the purpose of this study was to assess the prevalence of normal, borderline, and abnormal ECG changes in marathon runners.

METHODS

The 12-lead ECG data of 13,079 amateur marathon runners between the ages of 18 and 35 years were included for analysis. The prevalence of ECG abnormalities among different gender groups was compared with chi-square tests.

RESULTS

In terms of training-related changes, sinus bradycardia, sinus arrhythmia, and left ventricular high voltage were found in approximately 15, 5, and 3.28% of the participants, respectively. The incidence of right axis deviation in the marathon runners was 1.78%, which was slightly higher than the incidence of left axis deviation (0.88%). No more than 0.1% of the amateur marathon runners exhibited ST-segment depression, T wave inversion (TWI), premature ventricular contraction, pathologic Q waves, and prolonged QT interval.

CONCLUSIONS

Training-related ECG changes, including sinus bradycardia, sinus arrhythmia, and left ventricular high voltage, were common in amateur marathon runners. Most abnormal ECG changes, including ST-segment depression, TWI, premature ventricular contraction, pathologic Q waves, and prolonged QT interval, were infrequently found in amateur marathon runners. The data also suggested Chinese amateur marathon runners may have a relatively lower prevalence of ECG abnormalities than black and white runners.

Assessment of diagnostic accuracy of SanketLife - A wireless, pocket-sized ECG biosensor, in comparison to standard 12 lead ECG in the detection of cardiovascular diseases in a tertiary care setting

Background

The SanketLife is a low cost, portable, pocket sized 12 lead ECG mechanised by SanketLife app running on compatible iOS and Android phones that connect wirelessly via Bluetooth technology to the device.

Objective

The current study was conducted to assess the diagnostic accuracy of SanketLife ECG in comparison to standard 12 lead ECG (GE-2000) in detection of cardiovascular diseases.

Research design and methods

This was a prospective diagnostic test accuracy trial conducted in outpatient settings of a tertiary cardiac care centre in India. A total of 100 patients, attended cardiology OPD, were included in the study. Consecutive ECGs were taken by 12 lead standard ECG as well as by SanketLife ECG. Diagnostic accuracy variables such as sensitivity, specificity, negative and positive predictive value, negative and positive likelihood ratios were estimated. Ethical permission was taken from the Institutional ethical committee.

Results & conclusion

The analysis showed a high degree of agreement and accuracy of SanketLife in detecting major cardiovascular conditions (Major Minnesota codes) such as Left and right bundle branch block, ST-segment elevation and ST-segment depression, AV conduction block. SanketLife showed high sensitivity (98.15%) and specificity (100%) in diagnosing major cardiovascular conditions.

Smoking, heart rate, and ischemic stroke: a population-based prospective cohort study among Inner Mongolians in China

BACKGROUND AND PURPOSE

Smoking is a major public health challenge and an important risk factor for cardiovascular diseases. No previous studies have evaluated the association among smoking, heart rate, and ischemic stroke in an Inner Mongolian population. We aim to evaluate the cumulative effect of smoking and heart rate on ischemic stroke incidence in this population.

METHODS

A prospective cohort study from June 2003 through July 2012 was conducted among 2530 people ≥20 years of age from Inner Mongolia, China. We categorized the participants into 4 subgroups according to smoking status and heart rate. Cox proportional hazards models and receiver operating characteristic curves were used to evaluate the association among smoking, heart rate, and ischemic stroke.

RESULTS

The multivariate-adjusted hazard ratios (95% confidence intervals) of ischemic stroke incidence for nonsmokers with heart rate ≥80 bpm, smokers with heart rate <80 bpm, and smokers with heart rate ≥80 bpm were 1.42 (0.62-3.28), 2.11 (1.06-4.23), and 2.86 (1.33-6.14), respectively, compared with nonsmokers with heart rate <80 bpm. The area under receiver operating characteristic curve (area under the curve) for a model containing smoking status and heart rate, along with conventional factors (area under the curve=0.755), was significantly (P=0.018) larger than the one containing only conventional factors (area under the curve=0.739).

CONCLUSIONS

Our study indicated that smoking was an independent risk factor of ischemic stroke, and smokers with faster heart rate had the highest risk of ischemic stroke among Inner Mongolians. These findings suggest that smoking status and heart rate may be valuable in predicting ischemic stroke incidence.

Ancestry informative marker set for han chinese population

The population of Han Chinese is ∼1.226 billion people. Genetic heterogeneity between northern Han Chinese (N-Han) and southern Han Chinese (S-Han) has been demonstrated by recent genome-wide studies. As an initial step toward health disparities and personalized medicine in Chinese population, this study developed a set of ancestry informative markers (AIM) for Han Chinese population.

Diabetes, pre-diabetes and associated risks on Minnesota code-indicated major electrocardiogram abnormality among Chinese: a cross-sectional diabetic study in Fujian province, southeast China

The goal of this study was to determine the prevalence of diabetes mellitus (DM), impaired glucose regulation (IGR) and related metabolic disorders (overweight, obesity and hypertension) in a Chinese population (20-74 years old). An additional goal was to investigate the relationship between glucose metabolism and the Minnesota code-indicated major abnormal electrocardiogram (MA-ECG). There were 3960 individuals selected from urban and rural areas of Fujian, China from July 2007 to May 2008 by multistage-stratified sampling. Ultimately, data from 3208 subjects (20-74 years old) were analysed (including physical measurements, blood biochemical analysis, oral glucose tolerance test and 12-lead resting ECG). According to World Health Organization diagnostic criteria, the prevalence rates of DM and IGR were 9.51% (male, 10.08%; female, 9.14%) and 14.40% (male, 14.48%; female, 14.35%) respectively. Newly diagnosed DM was found in 53.44% of the diabetic subjects. Based on the 2000 China census, the age-standardized prevalence rates of DM and IGR were 7.19% (male, 7.74%; female, 6.61%) and 11.96 % (male, 12.35%; female, 11.56%) respectively. The age-standardized prevalence rates of DM and IGR in urban areas (7.74% and 12.97% respectively) were slightly but no significantly higher than in rural areas (6.67%, 10.86%). The prevalence rates of overweight, obesity and hypertension were 25.50%, 3.52% and 28.52% respectively (age- and sex- standardized rates: 23.69%, 3.02 % and 22.45 %). After adjusting for other confounding risk factors, multiple logistic regression analysis showed that DM and impaired glucose tolerance were independent risk factors for MA-ECG. Non-diabetic subjects with increased 30-min plasma glucose (PG) after an oral glucose load had a higher risk of MA-ECG after adjusting for other risk factors, especially in those with normal glucose tolerance but with 30-min PG >or= 7.8 mmol L(-1) (odds ratio = 1.371 [1.055-1.780]). The prevalence rates of DM and IGR as well as other metabolic disorders have increased dramatically in the last decade in China, especially in rural areas, with many undiagnosed cases of DM. Even slightly elevated PG levels may predict early cardiovascular events.

Asymptomatic myocardial ischaemia in HIV-infected adults

BACKGROUND

Asymptomatic ischaemic heart disease (IHD) in HIV-infected patients has not been studied.

METHODS

Resting, 12-lead electrocardiograms (ECG) were evaluated for asymptomatic IHD (Q-wave and/or ST segment depression) at baseline from HIV-infected participants with no known IHD enrolling in the SMART study. The ECG recordings were standardized and centrally analysed. Factors associated with asymptomatic IHD were identified by logistic regression, sequentially adjusted for demographics, clinical history, metabolic risk factors and type and duration of antiretroviral therapy (ART).

RESULTS

Of 4831 participants with an evaluable, baseline ECG and no prior IHD, mean age was 44 years (SD, 9.3); 28.4% were female; 6.6% had diabetes; 16.5% were receiving antihypertensive therapy; and 95.4% were ART experienced. ECG evidence of IHD was detected in 526 (10.9%) [Q-wave in 283 (5.9%), ST segment depression in 264 (5.5%)]; 16.7% in those 60 years or older. Variables independently associated with these abnormalities were older age [age > or= 60 versus < 40 years: odds ratio (OR), 2.2; 95% confidence interval (CI), 1.5-3.2; P < 0.001], current antihypertensive therapy (OR, 1.5; 95% CI, 1.1-1.9; P = 0.003) and recruitment in Europe (OR, 1.4; 95% CI, 1.1-1.7; P = 0.004) or Asia (OR, 1.6; 95% CI, 1.0-2.6; P = 0.05), both compared with North America. Diabetes was borderline significant (OR, 1.4; 95% CI, 1.0-2.0; P = 0.06).

CONCLUSIONS

ECG evidence of asymptomatic IHD was common in this large cohort of HIV-infected adults and more common than a history of symptomatic IHD. Traditional factors were the predominant determinants of risk. No clear association between ART type or duration and asymptomatic IHD was noted.

ECG abnormalities in the elderly: prevalence, time and generation trends and association with mortality

BACKGROUND AND AIMS

Electrocardiographic (ECG) abnormalities are often found in older patients but relatively few epidemiological studies have been performed. This study describes: a) cross-sectional differences in ECG abnormalities among three 70-year-old cohorts born over a period of 30 years; b) longitudinal changes in ECG abnormalities from the age of 70 to 85; and c) the relationship between ECG abnormalities at age 70 and subsequent 10- and 15-year mortality in men and women.

METHODS

Trends in the prevalence of ECG abnormalities were investigated among 2100 70-year olds (994 men, 1106 women) from three cohorts born in 1901/02 (I), 1911/12 (III) and 1930 (VI). Longitudinal changes and mortality risks were investigated among 973 70-year olds (449 men and 524 women) from cohort I, which was followed from 1971 until 2001.

RESULTS

In both sexes, the prevalence of ECG abnormalities was significantly lower in the later-born cohorts. From age 70 to 85, there was an increase in both men and women of large or intermediate Q-waves, left axis deviation, negative T-waves (0-5 mm), complete right bundle branch block (RBBB), and atrial fibrillation or flutter. Compared with those with no ECG abnormalities, the mortality risk was higher among individuals with large and intermediate Q-waves and negative T-waves (> or = 1 mm) in both sexes, and STJ depression > or = 0.5 mm and complete LBBB together with complete RBBB and intraventricular block; QRS > or = 0.12 sec in men only.

CONCLUSIONS

ECG abnormalities are frequent in the elderly, they increase with age, and are associated with increased mortality.