title: Long-Term Prognosis of Brugada-Type ECG and ECG With Atypical ST-Segment Elevation in the Right Precordial Leads Over 20 Years: Results From the Circulatory Risk in Communities Study (CIRCS).
abstract: Brugada syndrome is recognized as being associated with sudden cardiac death; however, the prevalence of non-type 1 Brugada-type ECG (BrS) or atypical ST-segment elevation in the right precordial leads (STERP) and the long-term prognosis for those patients remain unknown.
  
  
  
  We analyzed standard 12-lead ECGs of 7178 apparently healthy participants (age range 40-64 years) who underwent health checkups from 1982 to 1986 in the Circulatory Risk in Communities Study, a prospective, large, community-based cohort study in Japan. ECGs with J point amplitude ≥0.2 mV in the right precordial leads were divided into 3 groups: (1) type 1 BrS, (2) type 2 or 3 BrS (non-type 1 BrS), and (3) STERP. The others served as the non-ST-segment elevation group. We identified 8 participants (0.1%) with type1 BrS, 84 (1.2%) with non-type 1 BrS, and 228 (3.2%) with STERP. During a median follow-up of 18.7 years (133 987.0 person-years), sudden cardiac death was observed in no participants (0.0%) with type 1 BrS, in 1 (1.2%) with non-type 1 BrS, in 7 (3.1%) with STERP, and in 50 (0.7%) with non-ST-segment elevation. Participants with STERP had a markedly elevated risk of sudden cardiac death (multivariable hazard ratio 3.9, 95% CI 1.7-9.0).
  
  
  
  STERP was associated with an elevated risk of sudden cardiac death in a middle-aged population.
authors: Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
authors: Hidekazu
authors: H
authors: Tsuneoka
authors: Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors: Masahiko
authors: M
authors: Takagi
authors: Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
authors: Nobuyuki
authors: N
authors: Murakoshi
authors: Department of Public Health Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan.
authors: Kazumasa
authors: K
authors: Yamagishi
authors: Department of Cardiovascular Medicine, Disaster Medical Center, Tokyo, Japan.
authors: Yasuhiro
authors: Y
authors: Yokoyama
authors: Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
authors: DongZhu
authors: D
authors: Xu
authors: Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
authors: Yukio
authors: Y
authors: Sekiguchi
authors: Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
authors: Hiro
authors: H
authors: Yamasaki
authors: Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
authors: Yoshihisa
authors: Y
authors: Naruse
authors: Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
authors: Yoko
authors: Y
authors: Ito
authors: Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
authors: Miyako
authors: M
authors: Igarashi
authors: Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan.
authors: Akihiko
authors: A
authors: Kitamura
authors: Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan.
authors: Takeo
authors: T
authors: Okada
authors: Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan.
authors: Takeshi
authors: T
authors: Tanigawa
authors: Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
authors: Keisuke
authors: K
authors: Kuga
authors: Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
authors: Tetsuya
authors: T
authors: Ohira
authors: Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
authors: Hiroshi
authors: H
authors: Tada
authors: Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan kaonuma@md.tsukuba.ac.jp.
authors: Kazutaka
authors: K
authors: Aonuma
authors: Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
authors: Hiroyasu
authors: H
authors: Iso
mesh_terms: D000328:Adult; D053840:Brugada Syndrome / Q000175:diagnosis* / Q000503:physiopathology; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D012398:Ross River virus; D000072657:ST Elevation Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology
keywords: Brugada syndrome; electrocardiography; epidemiology; prognosis; sudden cardiac death