Baek Yong-Soo, Park Sang-Don, Lee Man-Jong, Kwon Sung-Woo, Shin Sung-Hee, Woo Sung-Il, Kwan Jun, Kim Dae-Hyeok
Division of Cardiology, Inha University Hospital, Incheon, South Korea.
Ann Noninvasive Electrocardiol. 2015 Sep;20(5):464-73. doi: 10.1111/anec.12302. Epub 2015 Aug 25.
J waves are associated with increased vagal activity in patients with idiopathic ventricular fibrillation in several studies to date. However, the relationship between J waves and autonomic nervous activity in patients without structural heart disease remains under investigation. We investigated whether the presence of a J wave on the surface electrocardiogram (ECG) was related to increased vagal activity in patients without structural heart disease.
This retrospective study included 684 patients without structural heart disease who had undergone Holter ECG and surface ECG monitoring. Based on the presence of J waves on the surface ECG, patients were divided into two groups: those with J waves (group 1) and those without J waves (group 2). We compared heart rate variability (HRV), reflecting autonomic nervous activity, using 24-h Holter ECG between the groups.
J waves were present in 92 (13.4%) patients. Heart rate (HR) in group 1 was significantly lesser than that in group 2 (P = 0.031). The ratio of low-frequency (LF) components to high-frequency (HF) components (LF/HF) in group 1 was significantly lower than that in group 2 (P = 0.001). The square root of the mean squared differences of successive NN intervals in group 1 was also significantly higher than that in group 2 (P = 0.047). In a multivariate regression analysis, male sex, HR, and LF/HF ratio remained independent determinants for the presence of J waves (P = 0.039, P = 0.036, and P < 0.001, respectively).
In patients without structural heart disease, the presence of a J wave was associated with a slow HR, male sex, and increased vagal activity, independently.
在目前的多项研究中，J波与特发性室颤患者迷走神经活动增加有关。然而，无结构性心脏病患者中J波与自主神经活动之间的关系仍在研究中。我们调查了体表心电图（ECG）上J波的存在是否与无结构性心脏病患者迷走神经活动增加有关。
这项回顾性研究纳入了684例接受动态心电图和体表心电图监测的无结构性心脏病患者。根据体表心电图上是否存在J波，将患者分为两组：有J波组（第1组）和无J波组（第2组）。我们使用24小时动态心电图比较了两组间反映自主神经活动的心率变异性（HRV）。
92例（13.4%）患者存在J波。第1组的心率（HR）显著低于第2组（P = 0.031）。第1组低频（LF）成分与高频（HF）成分的比值（LF/HF）显著低于第2组（P = 0.001）。第1组连续NN间期均方根差值也显著高于第2组（P = 0.047）。在多因素回归分析中，男性、HR和LF/HF比值仍然是J波存在的独立决定因素（分别为P = 0.039、P = 0.036和P < 0.001）。
在无结构性心脏病患者中，J波的存在与HR减慢、男性及迷走神经活动增加独立相关。
