J波与肺癌心脏侵犯之间的关系。
The relationship between J waves and contact of lung cancer with the heart.
作者信息
Hayashi Hideki, Wu Qi, Horie Minoru
机构信息
Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu City, Shiga, Japan.
出版信息
Ann Noninvasive Electrocardiol. 2017 Sep;22(5). doi: 10.1111/anec.12433. Epub 2017 Mar 16.
BACKGROUND
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.
METHODS
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.
RESULTS
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.
CONCLUSION
The presence of J waves was associated with the contact of lung cancer with the heart.
背景
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。
方法
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。
结果
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。
结论
J波的出现与肺癌和心脏的接触有关。
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