title: Race- and sex-associated differences in rate-adjusted QT, QTpeak, ST elevation and other regional measures of repolarization: the Atherosclerosis Risk in Communities (ARIC) Study.
abstract: BACKGROUND
  Data are limited about race-and sex-associated differences in prognostically important ECG measures of regional repolarization.
  
  
  RESULTS
  The normal reference group from the Atherosclerosis Risk in Communities (ARIC) study included 8,676 white and African-American men and women aged 40-65 years. Exclusion criteria included cardiovascular disease, hypertension, diabetes and major ECG abnormalities. Notable sex differences (p<0.001) were observed in the upper 98% limits for rate-adjusted QTend (QTea) which was 435 ms in white and African-American men and 445 ms in white and African-American women, and for left ventricular epicardial repolarization time (RTepi) which was 345 ms in white and African-American men and 465 ms in white and African-American women. These sex differences reflect earlier onset and end of repolarization in men than in women. Upper normal limits for STJ amplitude in V2-V3 were 100 μV in white and African-American women, 150 μV in white men and 200 μV in African-American men (p<0.001 for sex differences), and for other chest leads, aVL and aVF 50 μV in white women, 100 μV in African-American women, 100 μV in white men and 150 μV in African-American men (p<0.001 for sex and race differences).
  
  
  CONCLUSIONS
  Shorter QTea and RTepi in men than in women reflect earlier onset and end of repolarization in men. STJ amplitudes in African-American men were higher than in other subgroups by race and sex. These sex and race differences need to be considered in clinical and epidemiological applications of normal standards.
authors.affiliation: Epidemiological Cardiology Research Center (EPICARE), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC. Electronic address: pentti.rautaharju@gmail.com.
authors.forename: Pentti M
authors.initials: PM
authors.lastname: Rautaharju
authors.affiliation: Epidemiological Cardiology Research Center (EPICARE), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC.
authors.forename: Zhu-Ming
authors.initials: ZM
authors.lastname: Zhang
authors.affiliation: Department of Medicine, Section on Cardiology, Wake Forest School of Medicine, Winston Salem, NC.
authors.forename: Wesley K
authors.initials: WK
authors.lastname: Haisty
authors.affiliation: Advanced Algorithms Research Center, Philips Healthcare, Andover, MA.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Gregg
authors.affiliation: Dalhousie University, Halifax, NS, Canada.
authors.forename: James
authors.initials: J
authors.lastname: Warren
authors.affiliation: Dalhousie University, Halifax, NS, Canada.
authors.forename: Milan B
authors.initials: MB
authors.lastname: Horaĉek
authors.affiliation: Department of Epidemiology and Community Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Kucharska-Newton
authors.affiliation: Department of Epidemiology and Community Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Wayne
authors.initials: W
authors.lastname: Rosamond
authors.affiliation: Epidemiological Cardiology Research Center (EPICARE), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC; Department of Medicine, Section on Cardiology, Wake Forest School of Medicine, Winston Salem, NC.
authors.forename: Elsayed Z
authors.initials: EZ
authors.lastname: Soliman
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000453:epidemiology*; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000453:epidemiology*; D004562:Electrocardiography / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D044465:White People / Q000706:statistics & numerical data*
keywords: Electrocardiogram; QT; Race; ST-T wave; Sex