Development and application of a longitudinal electrocardiogram repository: the Framingham Heart Study

The electrocardiogram (ECG) has widespread use in clinical care and research. Despite its extensive use and study, important gaps remain in examining prospective, repeated longitudinal ECG measures, and their association with cardiovascular outcomes. The Framingham Heart Study (FHS) is a community-based study designed to examine risk factors and outcomes associated with cardiovascular disease. Here, we describe a novel effort in the FHS to develop a unique resource: serial ECGs conducted on 3 generations of study participants spanning multiple decades (1986 to the present). We describe the FHS and the role the ECG has had in conducting cardiovascular epidemiology in the FHS. We then describe potential applications for a longitudinal ECG repository. We expect the Framingham ECG repository to enhance cardiovascular research and epidemiologic study. Such a resource will complement the phenotypic and genotypic characterization of FHS, facilitating novel investigations of cardiovascular epidemiology.