ArticleAnnals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc2026
Prognostic Value of Spatial Trajectory of J-Point Amplitude Across Left Precordial Leads in a Community-Based Population.
Article in Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionEarly repolarization has historically been regarded as benign in many settings, although specific J-point features have been linked to adverse outcomes. Whether spatial variation in J-point amplitude across adjacent precordial leads carries prognostic information remains unclear.
methodsThis retrospective cohort study included participants aged 40-90 years without self-reported myocardial infarction or heart failure from the Third National Health and Nutrition Examination Survey (NHANES-III). Latent class trajectory analysis was used to identify spatial trajectories of J-point amplitude across leads V4-V6. The primary outcomes were all-cause mortality and cardiac death. Cox proportional hazards regression and competing risk models were used to evaluate associations between J-point trajectory patterns and outcomes.
resultsAmong 5696 eligible participants, the mean age was 57.6 ± 12.9 years, 3092 were women, and 3986 were non-Hispanic White. LCTA identified two spatial trajectories: Class 1 included 5295 participants and showed a low, mildly decreasing amplitude pattern, whereas Class 2 included 401 participants and showed higher V4 amplitude with a steeper decline toward V5-V6. During a median follow-up of 303 months, all-cause deaths occurred in 2935 and 257 participants, with 790 and 87 cardiac deaths, respectively. In fully adjusted models, Class 2 was associated with higher risks of all-cause mortality (HR, 1.20; 95% CI, 1.03-1.39) and cardiac death (HR, 1.31; 95% CI, 1.01-1.71).
conclusionA steep V4-to-V6 decline in J-point amplitude was associated with increased long-term all-cause and cardiac mortality. This spatial ECG phenotype may capture prognostic information beyond conventional early repolarization criteria and warrants external validation.
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