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
目的观察早复极波患者心率变异性的变化,探讨其意义。方法回顾分析85例早复极患者的资料与85例对照组进行心率变异性的对比分析,比较其特点。早复极组根据心电图J波抬高的程度分为J波≥2 m V(A组)和J波<2 m V(B组)两个亚组,分析两亚...目的观察早复极波患者心率变异性的变化,探讨其意义。方法回顾分析85例早复极患者的资料与85例对照组进行心率变异性的对比分析,比较其特点。早复极组根据心电图J波抬高的程度分为J波≥2 m V(A组)和J波<2 m V(B组)两个亚组,分析两亚组之间心率变异性的特点。结果早复极波组患者与对照组的心率变异时域指标比较,各指标比较差异有统计学意义(P<0.05)。早复极A组和B组时域指标比较,A组的SDNN、RMSSD、PNN50与B组比较,差异有统计学意义(P<0.05)。早复极组A组和B组频域指标比较,A组的HF、LF/HF与B组比较,差异有统计学意义(P<0.05)。结论早复极波患者的自主神经调节功能存在失衡,早复极患者J波幅度与自主神经功能失衡有关,主要表现为交感神经正常,迷走神经张力增高且张力强度与J波幅度正相关。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.
文摘目的观察早复极波患者心率变异性的变化,探讨其意义。方法回顾分析85例早复极患者的资料与85例对照组进行心率变异性的对比分析,比较其特点。早复极组根据心电图J波抬高的程度分为J波≥2 m V(A组)和J波<2 m V(B组)两个亚组,分析两亚组之间心率变异性的特点。结果早复极波组患者与对照组的心率变异时域指标比较,各指标比较差异有统计学意义(P<0.05)。早复极A组和B组时域指标比较,A组的SDNN、RMSSD、PNN50与B组比较,差异有统计学意义(P<0.05)。早复极组A组和B组频域指标比较,A组的HF、LF/HF与B组比较,差异有统计学意义(P<0.05)。结论早复极波患者的自主神经调节功能存在失衡,早复极患者J波幅度与自主神经功能失衡有关,主要表现为交感神经正常,迷走神经张力增高且张力强度与J波幅度正相关。
