Department of Cardiology, International University of Health and Welfare Narita Hospital, Narita, Chiba, Japan.
Department of Cardiology, International University of Health and Welfare Mita Hospital, Minato-ku, Tokyo, Japan.
Pacing Clin Electrophysiol. 2023 Aug;46(8):868-874. doi: 10.1111/pace.14787. Epub 2023 Jul 18.
J-waves may be observed during coronary angiography (CAG) or intracoronary acetylcholine (ACh) administration, but their significance is unknown.
Forty-nine patients, 59.1 ± 11.5 years old and 59% male, were studied on suspicion of vasospastic angina, and J wave dynamicity was compared between CAG and Ach administration.
Diagnostic (≥0.1 mV) or nondiagnostic (<0.1 mV) J waves in 9 and 3 patients, respectively, were augmented, and J waves were newly observed in 2 patients during CAG and Ach administration. Similar changes in the J-wave amplitude were observed: from 0.10 ± 0.09 mV to 0.20 ± 0.15 mV (p < .002) and from 0.10 ± 0.10 mV to 0.20 ± 0.16 mV (p < .001) during CAG and Ach administration, respectively. J waves were located in the inferior leads and changed only during the right coronary interventions. In the remaining 35 patients, J waves were absent before and during the coronary interventions. Augmentation of J waves was found when the RR interval was shortened in some patients. Injection of anoxic media into the coronary artery might induce a conduction delay from myocardial ischemia that manifests as augmentation or new occurrence of J waves.
Both CAG and intracoronary Ach administration affected J waves similarly in the same individuals. A myocardial ischemia-induced conduction delay may be responsible for the changes in J waves, but further studies are needed.
在冠状动脉造影（CAG）或冠状动脉内乙酰胆碱（ACh）给药期间可能会观察到 J 波，但它们的意义尚不清楚。
怀疑患有血管痉挛性心绞痛的 49 名患者（59.1±11.5 岁，59%为男性）接受了研究，比较了 CAG 和 Ach 给药时 J 波的动态变化。
9 例和 3 例患者的诊断性（≥0.1 mV）或非诊断性（<0.1 mV）J 波分别增强，2 例患者在 CAG 和 Ach 给药期间新观察到 J 波。J 波振幅的变化相似：从 0.10±0.09 mV 增加至 0.20±0.15 mV（p<.002）和从 0.10±0.10 mV 增加至 0.20±0.16 mV（p<.001），分别在 CAG 和 Ach 给药期间。J 波位于下导联，仅在右冠状动脉介入时发生变化。在其余 35 例患者中，在冠状动脉介入前后 J 波均不存在。在一些患者中，当 RR 间隔缩短时，发现 J 波增强。向冠状动脉内注入缺氧介质可能会导致心肌缺血引起的传导延迟，表现为 J 波的增强或新出现。
在同一患者中，CAG 和冠状动脉内 Ach 给药均以相似的方式影响 J 波。心肌缺血引起的传导延迟可能是 J 波变化的原因，但需要进一步研究。
