Zhang Luyao, Dong Shujuan, Zhao Wenbo, Li Jingchao, Cui Luqian, Han Yongmei, Chu Yingjie
Department of Cardiology, Henan Provincial People's Hospital, Zhengzhou, Henan Province, 450003, People's Republic of China.
Int J Gen Med. 2021 Nov 23;14:8725-8735. doi: 10.2147/IJGM.S337638. eCollection 2021.
This study determined the ischaemic J wave pattern associated with ventricular fibrillation (VF).
A total of 262 patients diagnosed with ST-elevation myocardial infarction (STEMI) were recruited from October 2017 to September 2020. All data were collected and analysed, including baseline characteristics, electrocardiogram (ECG), coronary angiography (CAG), and examination outcomes.
There were 193 STEMI patients with J wave elevation but without an ischaemic J wave (NJ group) and 69 patients with an ischaemic J wave; the latter were then subgrouped into early repolarization pattern (ERP; n=62) and Brugada pattern groups (BrP [anteroseptal ERP]; n=7). Univariate and multivariate logistic regression analyses were used to clarify high-risk factors and characteristics of ischaemic J waves. Multivariate logistic regression analysis revealed that an ischaemic J wave (odds ratio [OR], 9.708; 95% CI, 2.570-36.664; P=0.01) independently predicted VF. In the subgroup analysis, BrP (OR, 31.214; 95% CI, 3.949-246.742; P=0.001), slur morphology of the ERP (OR, 8.15; 95% CI, 1.563-42.558; P<0.05), and the number of leads with an ischaemic J wave > 3 (OR, 16.174; 95% CI, 3.064-85.375; P=0.001) were significantly associated with VF occurrence after adjusting for multiple variables.
An ischaemic J wave is an independent risk factor for VF in STEMI patients. BrP, slur morphology, and > 3 leads with an ischaemic J wave could increase the incidence of VF.
本研究确定了与心室颤动（VF）相关的缺血性J波模式。
2017年10月至2020年9月共招募了262例诊断为ST段抬高型心肌梗死（STEMI）的患者。收集并分析了所有数据，包括基线特征、心电图（ECG）、冠状动脉造影（CAG）和检查结果。
有193例STEMI患者出现J波抬高但无缺血性J波（NJ组），69例患者有缺血性J波；后者再分为早期复极模式（ERP；n = 62）和Brugada模式组（BrP[前间隔ERP]；n = 7）。采用单因素和多因素逻辑回归分析来阐明缺血性J波的高危因素和特征。多因素逻辑回归分析显示，缺血性J波（比值比[OR]，9.708；95%置信区间，2.570 - 36.664；P = 0.01）独立预测VF。在亚组分析中，调整多个变量后，BrP（OR，31.214；95%置信区间，3.949 - 246.742；P = 0.001）、ERP的顿挫形态（OR，8.15；95%置信区间，1.563 - 42.558；P < 0.05）以及缺血性J波导联数>3（OR，16.174；95%置信区间，3.064 - 85.375；P = 0.001）与VF发生显著相关。
缺血性J波是STEMI患者发生VF的独立危险因素。BrP、顿挫形态以及>3个导联出现缺血性J波会增加VF的发生率。
