Hayashi Hideki, Wu Qi, Horie Minoru
Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu City, Shiga, Japan.
Ann Noninvasive Electrocardiol. 2017 Sep;22(5). doi: 10.1111/anec.12433. Epub 2017 Mar 16.
J waves result mainly from an increased density of transient outward current (I ). Mechanical stretch to the heart activates multiple signal transduction pathways, in which I may be involved. The purpose of this study was to test the hypothesis that mechanical contact of lung cancer with the heart may manifest J waves.
We reviewed 12-lead electrocardiograms to examine whether J waves were associated with contact of lung cancer with the heart. J waves were defied as an elevation of ≥0.1 mV at the junction between QRS complex and ST segment with either notching or slurring morphology. The locational interaction between lung cancer and the heart was determined by computed tomography image.
A total of 264 patients (176 men; mean 68.5 ± 10.7 years) with lung cancer were evaluated. The prevalence of J waves was 25.4% in the total population. J waves were present in 40 of 44 (90.9%) patients with the contact. In contrast, J waves were present in 25 of 220 (11.4%) patients without the contact. The sensitivity and specificity of the contact for J waves were 90.9% and 88.6%, respectively. The odds ratio of the contact with the heart to the presence of J waves was 78 (95% confidence interval 25.7-236.4). The appearance of J waves that coincided with the development of lung cancer was observed in 12 patients.
The presence of J waves was associated with the contact of lung cancer with the heart.
J波主要由瞬时外向电流（I ）密度增加所致。心脏的机械牵张可激活多种信号转导通路，I 可能参与其中。本研究旨在验证肺癌与心脏的机械接触可能表现为J波这一假说。
我们回顾了12导联心电图，以检查J波是否与肺癌和心脏的接触有关。J波定义为QRS波群与ST段交界处抬高≥0.1mV，伴有切迹或顿挫形态。通过计算机断层扫描图像确定肺癌与心脏的位置关系。
共评估了264例肺癌患者（176例男性；平均年龄68.5±10.7岁）。总体人群中J波的发生率为25.4%。有接触的44例患者中有40例（90.9%）出现J波。相比之下，无接触的220例患者中有25例（11.4%）出现J波。接触对J波的敏感性和特异性分别为90.9%和88.6%。心脏接触与J波出现的比值比为78（95%置信区间25.7 - 236.4）。12例患者中观察到J波的出现与肺癌的发生同时出现。
J波的出现与肺癌和心脏的接触有关。
