Fumimoto Tomoko, Ueyama Takeshi, Shimizu Akihiko, Yoshiga Yasuhiro, Ono Makoto, Kato Takayoshi, Ishiguchi Hironori, Okamura Takayuki, Yamada Jutaro, Yano Masafumi
Division of Cardiology, Yamaguchi University Graduate School of Medicine, Ube, Japan.
Division of Cardiology, Yamaguchi University Graduate School of Medicine, Ube, Japan.
J Cardiol. 2017 Sep;70(3):271-277. doi: 10.1016/j.jjcc.2016.12.003. Epub 2017 Jan 11.
There is little information about the relationship between J waves and the occurrence of ventricular fibrillation (VF) in patients with vasospastic angina (VSA). The present study aimed to assess the incidence of J waves and the occurrence of VF in patients with VSA.
The subjects consisted of 62 patients with VSA diagnosed by acetylcholine provocation tests in our institution from 2002 to 2014. We investigated the VF events, prevalence of J waves, and relationship between the VF events and J waves.
J waves were observed in 16 patients (26%) and VF events were documented in 11 (18%). The incidence of VF in the patients with J waves was significantly higher than that in those without J waves (38% vs 11%, p=0.026). J waves were observed in the inferior leads in 14 patients, lateral leads in 5, and anterior leads in 3. A univariate analysis indicated that the incidence of VF in the inferior leads of J wave positive patients (46%=6/14) was significantly (p=0.01) higher than that in the inferior leads of J wave negative patients (10%=5/48). The J waves in the anterior and/or lateral leads were not related to the incidence of VF. Notched type and slurred type J waves were not associated with VF. A multivariate analysis revealed that J waves in VSA patients were associated with VF [odds ratio (OR) 6.41, 95% confidence interval (CI) 1.37-29.93, p=0.02] and organic stenosis (OR 6.98, 95% CI 1.39-35.08, p=0.02). Further, J waves in the inferior leads were strongly correlated with VF (OR 11.85, 95% CI 2.05-68.42, p=0.006).
The results suggest that the existence of J waves, especially in the inferior leads, might be a risk factor for VF in VSA patients.
关于变异性心绞痛（VSA）患者中J波与心室颤动（VF）发生之间的关系，相关信息较少。本研究旨在评估VSA患者中J波的发生率及VF的发生情况。
研究对象包括2002年至2014年在我院通过乙酰胆碱激发试验诊断为VSA的62例患者。我们调查了VF事件、J波的发生率以及VF事件与J波之间的关系。
16例患者（26%）观察到J波，11例（18%）记录到VF事件。有J波的患者中VF的发生率显著高于无J波的患者（38%对11%，p = 0.026）。14例患者下壁导联观察到J波，5例侧壁导联，3例前壁导联。单因素分析表明，J波阳性患者下壁导联VF的发生率（46% = 6/14）显著高于J波阴性患者下壁导联（10% = 5/48）（p = 0.01）。前壁和/或侧壁导联的J波与VF的发生率无关。切迹型和顿挫型J波与VF无关。多因素分析显示，VSA患者中的J波与VF相关[比值比（OR）6.41，95%置信区间（CI）1.37 - 29.93，p = 0.02]以及器质性狭窄相关（OR 6.98，95% CI 1.39 - 35.08，p = 0.02）。此外，下壁导联的J波与VF密切相关（OR 11.85，95% CI 2.05 - 68.42，p = 0.006）。
结果表明，J波的存在，尤其是在下壁导联，可能是VSA患者发生VF的一个危险因素。
