J-wave syndromes. From cell to bedside
J-wave syndromes. From cell to bedside
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DOI：
10.1016/j.jelectrocard.2011.07.026
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发表时间：
2011-11-01
影响因子：
1.3
通讯作者：
Yan, Gan-Xin
中科院分区：
文献类型：
--
作者：
Antzelevitch, Charles;Yan, Gan-Xin
J 波是跟随表面心电图 QRS 波群的偏转，在人体中通常部分埋藏在 R 波中，表现为 J 点抬高。以 J 点抬高、QRS 终末部分模糊和 ST 段抬高为特征的早期复极 (ER) 模式早已被认识并认为是完全良性的。最近的研究提供的证据表明，下导联或下外侧导联的 ER 模式与危及生命的心律失常（称为早期复极综合征）的风险增加相关。早期复极综合征和 Brugada 综合征具有相似的心电图特征、临床结果、危险因素以及与 I 介导的 J 波放大相关的共同心律失常平台。尽管 Brugada 综合征和早期复极综合征在异常 J 波表现的幅度和导联位置方面有所不同，但它们可以被认为代表了表型表达的连续谱，称为 J 波综合征。早期复极综合征被提议分为 3 种亚型： 1 型，主要在侧心前导联中表现出 ER 模式，在健康男性运动员中普遍存在，在心室颤动幸存者中很少见； 2 型，主要在下导联或下外侧导联中显示 ER 模式，与较高的风险水平相关；而 3 型，在下、外侧和右心前导联中全面显示 ER 模式，与发生恶性心律失常的最高风险相关，并且通常与室颤风暴相关。 (C) 2011 Elsevier Inc. 保留所有权利。
The J wave, a deflection that follows the QRS complex of the surface electrocardiogram, is usually partially buried in the R wave in humans, appearing as a J-point elevation. An early repolarization (ER) pattern characterized by J-point elevation, slurring of the terminal part of the QRS, and ST-segment elevation has long been recognized and considered to be totally benign. Recent studies have presented evidence demonstrating that an ER pattern in inferior leads or inferolateral leads is associated with increased risk for life-threatening arrhythmias, named early repolarization syndrome. Early repolarization syndrome and Brugada syndrome share similar electrocardiographic characteristics, clinical outcomes, risk factors, as well as a common arrhythmic platform related to amplification of I-to-mediated J waves. Although Brugada syndrome and early repolarization syndrome differ with respect to the magnitude and lead location of abnormal J wave manifestation, they can be considered to represent a continuous spectrum of phenotypic expression, termed J-wave syndromes. Early repolarization syndrome has been proposed to be divided into 3 subtypes: type 1, displaying an ER pattern predominantly in the lateral precordial leads, is prevalent among healthy male athletes and rarely seen in ventricular fibrillation survivors; type 2, displaying an ER pattern predominantly in the inferior or inferolateral leads, is associated with a higher level of risk; whereas type 3, displaying an ER pattern globally in the inferior, lateral, and right precordial leads, is associated with the highest level of risk for development of malignant arrhythmias and is often associated with ventricular fibrillation storms. (C) 2011 Elsevier Inc. All rights reserved.