Naruse Yoshihisa, Nogami Akihiko, Harimura Yoshie, Ishibashi Mayu, Noguchi Yuichi, Sekiguchi Yukio, Sato Akira, Aonuma Kazutaka
Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Cardiovascular Division, Tsukuba Medical Center Hospital, Tsukuba, Ibaraki, Japan.
J Cardiovasc Electrophysiol. 2015 Aug;26(8):872-878. doi: 10.1111/jce.12691. Epub 2015 Jun 15.
We recently showed that the presence of J waves increases the risk of ventricular fibrillation (VF) occurrence in the early phase of an acute myocardial infarction (AMI). This study aimed to evaluate the clinical characteristics of VF occurrences in the early phase of an AMI between patients with and without J waves.
This retrospective, observational study included 281 consecutive patients with an AMI (69 ± 12 years; 207 men) in whom 12-lead ECGs before AMI onset could be evaluated. The patients were classified based on a VF occurrence <48 hours after AMI onset and the presence of J waves. J waves were electrocardiographically defined as an elevation of the terminal portion of the QRS complex of >0.1 mV from baseline in at least 2 contiguous inferior or lateral leads. VF occurred in 24 patients, and J waves were present in 37. VF occurrence was more prevalent in the patients with than without J waves (27% vs. 6%; P < 0.001). Among the 244 patients without J waves, peak creatine kinase level (P < 0.01), number of diseased coronary arteries (P < 0.01), and male sex (P < 0.05) were higher in the patients with than without VF occurrence. However, among the 37 patients with J waves, there was no significant difference in these variables. There was no association between the location of J waves and the infarct area.
In patients with AMI, those with J waves were more likely to develop VF and less likely to have high-risk clinical characteristics than those without J waves.
我们最近发现，J波的存在会增加急性心肌梗死（AMI）早期发生心室颤动（VF）的风险。本研究旨在评估有J波和无J波的AMI患者早期VF发生的临床特征。
这项回顾性观察性研究纳入了281例连续的AMI患者（69±12岁；207例男性），这些患者在AMI发作前的12导联心电图可以进行评估。根据AMI发作后<48小时内VF的发生情况和J波的存在对患者进行分类。J波在心电图上定义为至少2个相邻下壁或侧壁导联的QRS波群终末部分从基线抬高>0.1mV。24例患者发生VF，37例存在J波。有J波的患者比无J波的患者更易发生VF（27%对6%；P<0.001）。在244例无J波的患者中，发生VF的患者的肌酸激酶峰值水平（P<0.01）、病变冠状动脉数量（P<0.01）和男性比例（P<0.05）均高于未发生VF的患者。然而，在37例有J波的患者中，这些变量没有显著差异。J波的位置与梗死面积之间没有关联。
在AMI患者中，有J波的患者比无J波的患者更易发生VF，且具有高危临床特征的可能性更小。
