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2. Impact of age and sex on the long-term prognosis associated with early repolarization in the general population

Author

Heikki V. Huikuri, Jani T. Tikkanen, M. Juhani Junttila, Antti Eranti, Arttu Holkeri, Harri Rissanen, Aapo L. Aro, Tuomas Kenttä, Markku Heliövaara, Tuomas Kerola, M. Anette E. Haukilahti, Paul Knekt, Kardiologian yksikkö, HUS Heart and Lung Center, University of Helsinki, Päijät-Häme Welfare Consortium, HYKS erva, and Clinicum

Subjects
Male, Time Factors, Benign early repolarization, Epidemiology, 030204 cardiovascular system & hematology, Sudden cardiac death, Electrocardiography, J WAVE, 0302 clinical medicine, Heart Rate, Risk Factors, J-POINT ELEVATION, 030212 general & internal medicine, Finland, INFEROLATERAL EARLY REPOLARIZATION, OUTCOMES, education.field_of_study, medicine.diagnostic_test, Early repolarization, Incidence, Age Factors, BIRACIAL COHORT, Middle Aged, Prognosis, PREVALENCE, 3. Good health, Survival Rate, ELECTROCARDIOGRAPHIC PHENOTYPES, Population Surveillance, Ventricular Fibrillation, Female, Cardiology and Cardiovascular Medicine, Adult, medicine.medical_specialty, Population, Age and sex, Risk Assessment, 03 medical and health sciences, Sex Factors, Heart Conduction System, Physiology (medical), Internal medicine, medicine, Humans, education, Retrospective Studies, J wave, business.industry, Mean age, medicine.disease, PATTERN, Death, Sudden, Cardiac, 3121 General medicine, internal medicine and other clinical medicine, MALIGNANT FORM, Age groups, business, Follow-Up Studies
Abstract

Early repolarization (ER) has been linked to the risk of sudden cardiac death (SCD) in the general population, although controversy remains regarding risks across various subgroups.The purpose of this study was to investigate whether age and sex influence the prognostic significance of ER.We evaluated the 12-lead electrocardiograms of 6631 Finnish general population subjects age ≥30 years (mean age 50.1 ± 13.9 years; 44.5% men) for the presence of ER (J-point elevation ≥0.1 mV in ≥2 inferior/lateral leads) and followed them for 24.4 ± 10.3 years. We analyzed the association between ER and the risk of SCD, cardiac death, and all-cause mortality in subgroups according to age (50 or ≥50 years) and sex.ER was present in 367 of the 3305 subjects age50 years and in 426 of 3326 subjects ≥50 years. ER was not associated with any of the endpoints in the entire study population. After adjusting for clinical factors, ER was associated with SCD (hazard ratio [HR] 1.88; 95% confidence interval [CI] 1.16-3.07) in subjects50 but not in older subjects (interaction between ER and age group, P = .048). In the younger subgroup, women with ER had a high risk of SCD (HR 4.11; 95% CI 1.41-12.03), whereas among men ER was not associated with SCD. Finally, ER was not associated with cardiac mortality or all-cause mortality in either age group.ER is associated with SCD in subjects younger than 50 years, particularly in women, but not in subjects 50 years and older.

Published
2020
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4. Tumeur à cellules granuleuses : à propos d'une localisation vulvaire compliquée de métastases pulmonaires.

Author

Tawfiq, N., Sabri, S., Saiss, K., Bouchbika, Z., Benchekroun, N., Jouhadi, H., Sahraoui, S., and Benider, A.

Subjects
*VULVAR tumors, *CELL tumors, *VULVODYNIA, *CANCER radiotherapy, *CANCER relapse, *TUMOR treatment, *PATIENTS
Abstract

Résumé: La tumeur à cellules granuleuses ou tumeur d’Abrikossoff est une tumeur rare, ubiquitaire, d’évolution majoritairement bénigne. Les formes malignes représentent 1 à 3 % des cas. La localisation vulvaire est exceptionnelle. Nous rapportons l’observation d’une patiente âgée de 28ans qui était atteinte d’une localisation vulvaire d’une tumeur d’Abrikossoff. Initialement considérée comme bénigne, elle a été traitée par chirurgie locale exclusive. Cinq mois plus tard, cette tumeur connaissait une transformation maligne ; la tumeur mesurait 14cm avec la présence des mitoses éparses non systématisées, exprimait PS100 à 100 % et le Ki 67 à 20 %. Du fait du caractère malin et de l’exérèse économique du néoplasme, la patiente a reçu une radiothérapie adjuvante dans le lit tumoral et les ganglions inguinaux 50Gy. Après 20 mois, la patiente a été atteinte d’une rechute locale et pulmonaire en lâcher de ballons, renforçant ainsi le diagnostic de malignité. Elle a reçu deux lignes de chimiothérapie, 5-fluoro-uracile et cisplatine, et paclitaxel et carboplatine sans aucune réponse. Suite à l’échec de la chimiothérapie, la patiente a été mise sous traitement médical symptomatique. Cette observation incite à préconiser un traitement chirurgical agressif des sites tumoraux identifiés et surtout à exercer une surveillance clinique et radiologique rapprochée de toute tumeur à cellules granuleuses. [ABSTRACT FROM AUTHOR]

Published
2013
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5. Long-term prognostic significance of the ST level and ST slope in the 12-lead ECG in the general population

Author

Antti Jula, Tuomo Nieminen, Leo-Pekka Lyytikäinen, Mika Kähönen, Heini Huhtala, Harri Rissanen, Markku Eskola, Kjell Nikus, Jussi Hernesniemi, Tiia Istolahti, Terho Lehtimäki, Ismo Anttila, HYKS erva, Päijät-Häme Welfare Consortium, Lääketieteen ja terveysteknologian tiedekunta - Faculty of Medicine and Health Technology, Yhteiskuntatieteiden tiedekunta - Faculty of Social Sciences, and Tampere University

Subjects
Male, T-WAVE ABNORMALITIES, CARDIOVASCULAR MORTALITY, 12 lead ecg, Coronary Disease, 030204 cardiovascular system & hematology, Continuous variable, Electrocardiography, 0302 clinical medicine, Risk Factors, ST slope, 030212 general & internal medicine, Outcome, ST depression, RISK, education.field_of_study, Hazard ratio, Sisätaudit - Internal medicine, MEN, ASSOCIATION, Prognosis, 3. Good health, PREVALENCE, Cardiology, Population study, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Population, 03 medical and health sciences, Internal medicine, medicine, Humans, CORONARY-HEART-DISEASE, education, Aged, Proportional Hazards Models, business.industry, Proportional hazards model, ECG, SEGMENT, Arrhythmias, Cardiac, REPOLARIZATION, Confidence interval, ST level, 3121 General medicine, internal medicine and other clinical medicine, MALIGNANT FORM, business
Abstract

Background: Even minor ST depression in the electrocardiogram (ECG) is associated with cardiovascular disease and increased mortality. There is limited data on the prognostic significance of ST-level changes in the general population. Subjects and methods: A random sample of Finnish subjects (n = 6354) aged over 30 years (56.1% women) underwent a health examination including a 12-lead ECG in the Health 2000 survey. The effects of relative ST level as a continuous variable and ST slope (upsloping, horizontal, downsloping) in three different lead groups were analyzed using a multi-adjusted Cox proportional hazard model separately for men and women with total mortality as endpoint. Results: The follow-up lasted for 13.7 (SD 3.3) years for men and 13.9 (SD 3.1) years for women. Lower lateral ST levels were associated with all-cause mortality in multi-adjusted models in both genders (at.) + 80 ms hazard ratio [HR] 0.64 for a change of 1.0 mm [95% confidence interval 0.49-0.84, p = 0.002] for men and HR 0.61 [0.48-0.78, p

Published
2020

6. Conclusion

Author

Bradač, Gianni Boris, Ferszt, Ron, Kendall, Brian E., Bradač, Gianni Boris, editor, Ferszt, Ron, editor, and Kendall, Brian E., editor

Published
1990
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