Early repolarization syndrome(ERS), demonstrated as J-point elevation on an electrocardiograph, was formerly thought to be a benign entity, but the recent studies have demonstrated that it can be linked to a considera...Early repolarization syndrome(ERS), demonstrated as J-point elevation on an electrocardiograph, was formerly thought to be a benign entity, but the recent studies have demonstrated that it can be linked to a considerable risk of life- threatening arrhythmias and sudden cardiac death(SCD). Early repolarization characteristics associated with SCD include high-amplitude J-point elevation, horizontal and/or downslopping ST segments, and inferior and/or lateral leads location. The prevalence of ERS varies between 3% and 24%, depending on age, sex and J-point elevation(0.05 m V vs 0.1 m V) being the main determinants.ERS patients are sporadic and they are at a higher risk of having recurrent cardiac events. Implantable cardioverter-defibrillator implantation and isoproterenol are the suggested therapies in this set of patients. On the other hand, asymptomatic patients with ERS are common and have a better prognosis. The risk stratification in asymptomatic patients with ERS still remains a grey area. This review provides an outline of the up-to-date evidence associated with ERS and the risk of life- threatening arrhythmias. Further prospective studies are required to elucidate the mechanisms of ventricular arrhythmogenesis in patients with ERS.展开更多
Objective： The objective was to provide a brief history of J wave molecular, ionic, cellular mechanisms, and clinical features. We will clinical research for J wave syndromes. syndromes and to summarize our current u...Objective： The objective was to provide a brief history of J wave molecular, ionic, cellular mechanisms, and clinical features. We will clinical research for J wave syndromes. syndromes and to summarize our current understanding of their also discuss the existing debates and further direction in basic and Data Sources： The publications on key words of＂J wave syndromes＂, ＂early repolarization syndrome （ERS）＂, ＂Brugada syndrome （BrS）＂ and ＂ST-segment elevation myocardial infarction （STEMI）＂ were comprehensively reviewed through search of the PubMed literatures without restriction on the publication date. Study Selection： Original articles, reviews and other literatures concerning J wave syndromes, ERS, BrS and STEMI were selected. Results： J wave syndromes were firstly defined by Yah et al. in a Chinese journal a decade ago, which represent a spectrum of variable phenotypes characterized by appearance of prominent electrocardiographic J wave including ERS, BrS and ventricular fibrillation （VF） associated with hypothermia and acute STEMI. J wave syndromes can be inherited or acquired and are mechanistically linked to amplification of the transient outward current （I ）-mediated J waves that can lead to phase 2 reentry capable of initiating VF. Conclusions： J wave syndromes are a group of newly highlighted clinical entities that share similar molecular, ionic and cellular mechanism and marked by amplified J wave on the electrocardiogram and a risk of VF. The clinical challenge ahead is to identify the patients with J wave syndromes who are at risk for sudden cardiac death and determine the alternative therapeutic strategies to reduce mortality.展开更多
目的探讨采用动态心电图及运动平板诊断早期复极综合征的临床价值。方法选取我院2013年9月至2016年8月期间收治的早期复极综合征患者66例,诊断前均询问病史,行心脏超声、常规体检及血生化检查,排除器质性心脏疾病。患者均先进行运动平...目的探讨采用动态心电图及运动平板诊断早期复极综合征的临床价值。方法选取我院2013年9月至2016年8月期间收治的早期复极综合征患者66例,诊断前均询问病史,行心脏超声、常规体检及血生化检查,排除器质性心脏疾病。患者均先进行运动平板试验,然后行动态心电图检查,观察检查结果。结果心率越慢,T波高耸、ST段抬高越明显,而S T段向等电位线下降随着心率的加快表现越明显(r=0.952,P<0.05);66例患者中,诊断符合率为98.5%(65/66)。运动平板试验后ST段均开始回落。达到目标心率时,64例患者的ST段随之恢复等电位线,ST段水平压低0.10~0.15 m V,2例患者的持续时间不低于2min。休息20 min后,全部恢复运动前心电图水平,诊断符合率为100.0%。两种检查方式的诊断符合率比较差异无统计学意义(P>0.05)。结论早期复极综合征采用动态心电图和运动平板试验诊断均有较高的价值,可根据不同人群选择适宜方法。展开更多
文摘Early repolarization syndrome(ERS), demonstrated as J-point elevation on an electrocardiograph, was formerly thought to be a benign entity, but the recent studies have demonstrated that it can be linked to a considerable risk of life- threatening arrhythmias and sudden cardiac death(SCD). Early repolarization characteristics associated with SCD include high-amplitude J-point elevation, horizontal and/or downslopping ST segments, and inferior and/or lateral leads location. The prevalence of ERS varies between 3% and 24%, depending on age, sex and J-point elevation(0.05 m V vs 0.1 m V) being the main determinants.ERS patients are sporadic and they are at a higher risk of having recurrent cardiac events. Implantable cardioverter-defibrillator implantation and isoproterenol are the suggested therapies in this set of patients. On the other hand, asymptomatic patients with ERS are common and have a better prognosis. The risk stratification in asymptomatic patients with ERS still remains a grey area. This review provides an outline of the up-to-date evidence associated with ERS and the risk of life- threatening arrhythmias. Further prospective studies are required to elucidate the mechanisms of ventricular arrhythmogenesis in patients with ERS.
基金Sharpe-Strumia Research Foundation, and National Natural Science Foundation of China （No. 81400258, 81370289, 81270236）.
文摘Objective： The objective was to provide a brief history of J wave molecular, ionic, cellular mechanisms, and clinical features. We will clinical research for J wave syndromes. syndromes and to summarize our current understanding of their also discuss the existing debates and further direction in basic and Data Sources： The publications on key words of＂J wave syndromes＂, ＂early repolarization syndrome （ERS）＂, ＂Brugada syndrome （BrS）＂ and ＂ST-segment elevation myocardial infarction （STEMI）＂ were comprehensively reviewed through search of the PubMed literatures without restriction on the publication date. Study Selection： Original articles, reviews and other literatures concerning J wave syndromes, ERS, BrS and STEMI were selected. Results： J wave syndromes were firstly defined by Yah et al. in a Chinese journal a decade ago, which represent a spectrum of variable phenotypes characterized by appearance of prominent electrocardiographic J wave including ERS, BrS and ventricular fibrillation （VF） associated with hypothermia and acute STEMI. J wave syndromes can be inherited or acquired and are mechanistically linked to amplification of the transient outward current （I ）-mediated J waves that can lead to phase 2 reentry capable of initiating VF. Conclusions： J wave syndromes are a group of newly highlighted clinical entities that share similar molecular, ionic and cellular mechanism and marked by amplified J wave on the electrocardiogram and a risk of VF. The clinical challenge ahead is to identify the patients with J wave syndromes who are at risk for sudden cardiac death and determine the alternative therapeutic strategies to reduce mortality.
文摘目的探讨采用动态心电图及运动平板诊断早期复极综合征的临床价值。方法选取我院2013年9月至2016年8月期间收治的早期复极综合征患者66例,诊断前均询问病史,行心脏超声、常规体检及血生化检查,排除器质性心脏疾病。患者均先进行运动平板试验,然后行动态心电图检查,观察检查结果。结果心率越慢,T波高耸、ST段抬高越明显,而S T段向等电位线下降随着心率的加快表现越明显(r=0.952,P<0.05);66例患者中,诊断符合率为98.5%(65/66)。运动平板试验后ST段均开始回落。达到目标心率时,64例患者的ST段随之恢复等电位线,ST段水平压低0.10~0.15 m V,2例患者的持续时间不低于2min。休息20 min后,全部恢复运动前心电图水平,诊断符合率为100.0%。两种检查方式的诊断符合率比较差异无统计学意义(P>0.05)。结论早期复极综合征采用动态心电图和运动平板试验诊断均有较高的价值,可根据不同人群选择适宜方法。
