Second Department of Cardiology, Evangelismos General Hospital of Athens, 45-47 Ipsilantou Street, 10676 Athens, Greece.
Europace. 2012 Jun;14(6):877-81. doi: 10.1093/europace/eur390. Epub 2011 Dec 19.
The presence of early repolarization (ER) in inferior or inferolateral leads has been associated with malignant arrhythmias and increased mortality. Transmural dispersion of repolarization (TDR) has been proposed to underlie arrhythmogenesis in J-wave syndromes. The present study investigated specific electrocardiographic (ECG) markers including Tpeak-Tend interval and (Tpeak-Tend)/QT ratio that reflect TDR in subjects with ER.
The ECGs of 47 healthy individuals (43 males, mean age: 45.7 ± 13.1 years) with an ER pattern in lateral (n = 15) or infero-lateral leads (n = 32) who successfully completed an exercise stress test were analysed at rest, peak workload, and recovery. The ER pattern was defined as slurring or notching of the terminal part of the QRS complex (J-point) ≥ 1 mm, in at least two contiguous leads. Thirty-five age- and sex-matched healthy subjects without ER (28 males, mean age: 48.6 ± 10.2 years) served as comparative controls. Subjects with ER displayed increased Tpeak-Tend interval in lead V(2), Tpeak-Tend dispersion of the precordial leads, and (Tpeak-Tend)/QT ratio in lead V(2) compared with those without ER in all three phases of the exercise test (P < 0.05). In addition, Tpeak-Tend dispersion and the (Tpeak-Tend)/QT ratio in lead V(2) were significantly increased at recovery phase compared with peak exercise only in subjects with ER (P< 0.05). There were no significant differences among the studied ECG parameters regarding the ER location (lateral vs. infero-lateral), the ER type (slurring or notching), or the maximum J-point amplitude (≥ 1.5 vs. <1.5 mm) at baseline ECGs.
Individuals with ER display an increased TDR that may be related to an increased arrhythmic risk.
下壁或下外侧导联的早期复极（ER）与恶性心律失常和死亡率增加有关。跨壁复极离散度（TDR）被认为是 J 波综合征心律失常发生的基础。本研究旨在探讨 ER 患者中反映 TDR 的特定心电图（ECG）标志物，包括 Tpeak-Tend 间期和（Tpeak-Tend）/QT 比值。
对 47 名成功完成运动负荷试验的 lateral（n = 15）或 infero-lateral 导联（n = 32）ER 模式的健康个体（43 名男性，平均年龄：45.7 ± 13.1 岁）的 ECG 在静息、峰值负荷和恢复期进行分析。ER 模式定义为至少两个连续导联的 QRS 终末部分（J 点）≥1mm 的模糊或切迹。35 名年龄和性别匹配的无 ER 健康对照（28 名男性，平均年龄：48.6 ± 10.2 岁）作为对照组。与无 ER 组相比，ER 组在运动试验的所有三个阶段中 V(2)导联的 Tpeak-Tend 间期、胸前导联的 Tpeak-Tend 离散度和 V(2)导联的（Tpeak-Tend）/QT 比值均增加（P<0.05）。此外，仅在 ER 组中，与峰值运动相比，恢复期 Tpeak-Tend 离散度和 V(2)导联的（Tpeak-Tend）/QT 比值显著增加（P<0.05）。在基线 ECG 中，ER 位置（lateral 与 infero-lateral）、ER 类型（模糊或切迹）或最大 J 点振幅（≥1.5 与<1.5mm）方面，研究中的 ECG 参数之间无显著差异。
ER 患者的 TDR 增加，这可能与心律失常风险增加有关。
