Differences in 12-lead electrocardiogram between symptomatic and asymptomatic brugada syndrome patients
Differences in 12-lead electrocardiogram between symptomatic and asymptomatic brugada syndrome patients
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DOI：
10.1111/j.1540-8167.2007.01050.x
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发表时间：
2008-04-01
影响因子：
2.7
通讯作者：
Brugada, Ramon
中科院分区：
文献类型：
--
作者：
Junttila, M. Juhani;Brugada, Pedro;Brugada, Ramon
12导联心电图在有症状和无症状BRS之间的差异。前言：Brugada综合征(BRS)是一种遗传性疾病，易使某些受试者发生心脏性猝死(SCD)。目前还不能很好地确定BRS患者是否有严重心律失常的风险。我们的目的是研究标准的12导联心电图是否能为这一目的提供有用的信息。方法：这项研究包括200名BRS先证者(142名男性，62%；平均年龄42+/-16岁)。与BRS相关的症状被定义为晕厥、有记录的室性快速性心律失常或SCD。分别测定II和V-2导联的PR、QRS、QT_c、T峰和T-end间期，V-5导联的QRS、aVR导联的R‘/S比值(aVR征)、QRS轴和右侧胸前导联J点抬高幅度。结果：66例(33%)受试者有与BRS相关的症状。有症状和无症状患者之间的唯一显著差异是从II导联或V-2导联测量的QRS时限，例如，有症状的患者V-2的QRS平均为115+/-26ms，而无症状患者的QRS平均为104+/-19ms(P<；0.001)。以V-2QRS>；=120ms为最佳临界点，有症状的优势比(OR)为2.5(95%CI：1.4~4.6，P=0.003)。经性别、年龄和SCN5A突变校正的多因素分析，OR值为2.6(95%CI：1.4~4.8，P=0.004)。结论：标准12导联心电图测量的QRS间期延长与症状有关，可作为BRS患者易发生危及生命的室性心律失常的简单无创性危险标志。
Differences in 12-Lead ECG Between Symptomatic and Asymptomatic BrS. Introduction: Brugada syndrome (BrS) is an inherited disorder that predisposes some subjects to sudden cardiac death (SCD). It is not well established which BrS patients are at risk of severe arrhythmias. Our aim was to study whether standard 12-lead electrocardiogram (ECG) would give useful information for this purpose.Methods: This study included 200 BrS probands (142 male, 62%; mean age 42 +/- 16 years). Symptoms related to BrS were defined as syncope, documented ventricular tachyarrhythmia, or SCD. We determined PR, QRS, QTc, T-peak, and T-end interval from leads II and V-2 and QRS from lead V-5, R'/S ratio from lead aVR (aVR sign), QRS axis, and J-point elevation amplitude from right precordial leads from the baseline ECGs.Results: Sixty-six subjects (33%) had experienced symptoms related to BrS. The only significant difference between the symptomatic and asymptomatic BrS subjects was the QRS duration measured from lead II or lead V-2, for example, the mean QRS in V-2 was 115 +/- 26 ms in symptomatic versus 104 +/- 19 ms in asymptomatic patients (P < 0.001). The optimized cut-off point of V-2 QRS >= 120 ms gave an odds ratio (OR) of 2.5 (95% CI: 1.4-4.6, P = 0.003) for being symptomatic. In a multivariate analysis adjusted with gender, age, and SCN5A mutation, the OR was 2.6 (95% CI: 1.4-4.8, P = 0.004).Conclusion: Prolonged QRS duration, measured from standard 12-lead ECG, is associated with symptoms and could serve as a simple noninvasive risk marker of vulnerability to life-threatening ventricular arrhythmias in BrS.