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).
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).
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DOI：
10.1161/jaha.115.002899
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发表时间：
2016-08-08
影响因子：
5.4
通讯作者：
CIRCS Investigators
中科院分区：
文献类型：
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作者：
Tsuneoka H;Takagi M;Murakoshi N;Yamagishi K;Yokoyama Y;Xu D;Sekiguchi Y;Yamasaki H;Naruse Y;Ito Y;Igarashi M;Kitamura A;Okada T;Tanigawa T;Kuga K;Ohira T;Tada H;Aonuma K;Iso H;CIRCS Investigators
Brugada综合征被认为与心源性猝死相关;然而，非1型Brugada型ECG（BrS）或右胸导联非典型ST段抬高（STERP）的患病率以及这些患者的长期预后仍然未知。我们分析了1982年至1986年在社区循环风险研究中接受健康检查的7178名明显健康的参与者（年龄范围40-64岁）的标准12导联ECG，该研究是日本的一项前瞻性大型社区队列研究。将右胸导联J点振幅≥0.2 mV的ECG分为3组：（1）1型BrS，（2）2型或3型BrS（非1型BrS）和（3）STERP。其他患者作为非ST段抬高组。我们确定了8名参与者（0.1%）为1型BrS，84名（1.2%）为非1型BrS，228名（3.2%）为STERP。在中位随访18.7年（133 987.0人年）期间，未观察到1型BrS受试者（0.0%）、1例非1型BrS受试者（1.2%）、7例STERP受试者（3.1%）和50例非ST段抬高受试者（0.7%）发生心源性猝死。STERP参与者的心源性猝死风险显著升高（多变量风险比3.9，95% CI 1.7-9.0）。 STERP与中年人群心源性猝死风险升高相关。
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.