Rosso Raphael, Kogan Evgeni, Belhassen Bernard, Rozovski Uri, Scheinman Melvin M, Zeltser David, Halkin Amir, Steinvil Arie, Heller Karin, Glikson Michael, Katz Amos, Viskin Sami
Tel Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel.
J Am Coll Cardiol. 2008 Oct 7;52(15):1231-8. doi: 10.1016/j.jacc.2008.07.010.
The purpose of this study was to determine whether J-point elevation is a marker of arrhythmic risk.
J-point elevation has been considered an innocent finding among healthy young individuals (the "early repolarization" pattern). However, this electrocardiogram (ECG) finding is increasingly being associated with idiopathic ventricular fibrillation (VF).
In a case-control study, the ECG of 45 patients with idiopathic VF were compared with those of 124 age- and gender-matched control subjects and with those of 121 young athletes. We measured the height of J-point and ST-segment elevation and counted the presence of slurring in the terminal portion of the R-wave.
J-point elevation was more common among patients with idiopathic VF than among matched control subjects (42% vs. 13%, p = 0.001). This was true for J-point elevation in the inferior leads (27% vs. 8%, p = 0.006) and for J-point elevation in leads I to aVL (13% vs. 1%, p = 0.009). J-point elevation in V(4) to V(6) occurred with equal frequency among patients and matched control subjects (6.7% vs. 7.3%, p = 0.86). Male subjects had J-point elevation more often than female subjects and young athletes had J-point elevation more often than healthy adults but less often than patients with idiopathic VF. The presence of ST-segment elevation or QRS slurring did not add diagnostic value to the presence of J-point elevation.
J-point elevation is found more frequently among patients with idiopathic VF than among healthy control subjects. The frequency of J-point elevation among young athletes is intermediate (higher than among healthy adults but lower than among patients with idiopathic VF).
本研究旨在确定J点抬高是否为心律失常风险的标志物。
J点抬高在健康年轻个体中被认为是一种良性表现（“早期复极”模式）。然而，这种心电图（ECG）表现越来越多地与特发性室颤（VF）相关。
在一项病例对照研究中，将45例特发性VF患者的ECG与124例年龄和性别匹配的对照受试者以及121例年轻运动员的ECG进行比较。我们测量了J点和ST段抬高的高度，并计数R波终末部分顿挫的存在情况。
特发性VF患者中J点抬高比匹配的对照受试者更常见（42%对13%，p = 0.001）。下壁导联J点抬高情况如此（27%对8%，p = 0.006），I至aVL导联J点抬高情况也是如此（13%对1%，p = 0.009）。V(4)至V(6)导联J点抬高在患者和匹配对照受试者中出现频率相同（6.7%对7.3%，p = 0.86）。男性受试者J点抬高比女性受试者更常见，年轻运动员J点抬高比健康成年人更常见，但比特发性VF患者少见。ST段抬高或QRS顿挫的存在并未增加J点抬高的诊断价值。
特发性VF患者中J点抬高比健康对照受试者更频繁被发现。年轻运动员中J点抬高频率处于中间水平（高于健康成年人但低于特发性VF患者）。
