Introduction
Early repolarization pattern (ERP) is defined as an elevation of the J point in at least 2 leads, as either QRS slurring and notching1. For decades, it was believed to be a benign electrocardiographic manifestation 2,3. Since the early 2000s, this view has been changed based on sporadic observations that linked the J wave with ventricular arrhythmias
1,4,5. The pathophysiological mechanism of arrhythmic events in ERP was primarily explained by electrophysiological alterations 6-8. Besides, recent studies have demonstrated a significant association between ERP and myocardial structural changes including increased left ventricular (LV) mass and change in LV geometry as well as functional LV alterations such as impaired LV filling 9,10. Although the relationship between ERP and myocardial structural changes clearly has been shown, it is not exact whether ERP own leads to myocardial dysfunction.
2D speckle tracking echocardiography (2D-STE) has higher diagnostic value in detecting subtle myocardial dysfunction than 2D- transthoracic echocardiography (TTE) 11-13. This is due to the most important reason is that 2D- STE is more sensitive to make differentiation of passive and active myocardial displacement by tracking small myocardial speckles and following them from frame to frame over cardiac cycle 11. In ERP individuals, STE can facilitate to detect a silent substrate for arrhythmic events as well as the findings of STE can be used for risk stratification of ventricular arryhtmias in the future. In this study, we aimed to investigate LV function by the using 2D-STE in individuals with ERP and to compare these findings with individuals who have normal electrocardiographic pattern.