Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
JACC Clin Electrophysiol. 2018 Jun;4(6):724-730. doi: 10.1016/j.jacep.2018.02.009. Epub 2018 Mar 28.
The principal objective was to perform an initial test of the Shanghai Brugada Scoring System. Diagnosis of probable and/or definite Brugada syndrome (BrS), possible BrS, and nondiagnostic outcomes were assigned scores of ≥3.5, 2 to 3, and <2 points, respectively. The proposed score system was based on the available published reports and on weighted coefficients derived from limited datasets, with the understanding that these recommendations would need to undergo continuing validation.
The 2016 HRS/EHRA/APHRS/SOLAECE J-Wave Syndrome Consensus Report proposed a scoring system for diagnosis of BrS that takes into account electrocardiographic recordings, genetic results, clinical characteristics, and family history.
The patient population consisted of 393 patients evaluated at our hospital for BrS (271 asymptomatic, 99 with syncope, and 23 with ventricular fibrillation [VF]) between 1996 and 2016. Subjects were classified into 4 groups: group A with a score of ≤3.0 points (n = 45); group B with a score of 3.5 points (n = 186); group C with a score of 4.0 to 5.0 points (n = 81); and group D with a score of ≥5.5 points (n = 81).
A total of 348 (88%) patients had probable and/or definite BrS, and 81 (20%) had a score ≥5.5. During a follow-up of 97.3 months (range: 39.7 to 142.1 months), 43 patients experienced VF. Significant differences were seen among the 4 groups (p = 0.01). A malignant arrhythmic event did not occur in any patient with possible or nondiagnostic BrS.
This study provided validation for the use of the Shanghai Score System for the diagnosis and risk stratification of patients with BrS.
本研究旨在初步验证上海 Brugada 评分系统。疑似和/或明确 Brugada 综合征（BrS）、可能 BrS 和非诊断性结果分别赋值≥3.5、2-3 和<2 分。该评分系统基于已发表的文献和从有限数据集得出的加权系数，同时理解这些建议需要持续验证。
2016 年 HRS/EHRA/APHRS/SOLAECE J-Wave 综合征共识报告提出了一种 Brugada 综合征诊断评分系统，该系统考虑了心电图记录、基因结果、临床特征和家族史。
本研究纳入了 1996 年至 2016 年在我院接受 Brugada 综合征评估的 393 例患者（271 例无症状、99 例晕厥和 23 例心室颤动[VF]）。将患者分为 4 组：A 组评分≤3.0 分（n=45）；B 组评分 3.5 分（n=186）；C 组评分 4.0-5.0 分（n=81）；D 组评分≥5.5 分（n=81）。
348 例（88%）患者存在疑似和/或明确 BrS，81 例（20%）评分≥5.5。随访 97.3 个月（范围：39.7-142.1 个月）期间，43 例患者发生 VF。4 组间差异具有统计学意义（p=0.01）。在可能或非诊断性 BrS 患者中，无一例发生恶性心律失常事件。
本研究为上海评分系统用于 Brugada 综合征患者的诊断和风险分层提供了验证。
