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目的:探讨肥厚型心肌病(HCM)患者标准12导联体表心电图(ECG)J点抬高(J波)与心脏骤停(SCA)之间的关系。方法:入选北京7家三级甲等医院345例HCM患者,采集所有入选者静息标准12导联体表心电图。J波定义为在下壁(Ⅱ、Ⅲ和aVF)、侧壁(V4~V6导联)或高侧壁(Ⅰ和aVL)连续2个及以上导联出现J点较基线抬高≥0.1mV。SCA包括心脏性猝死(SCD)、有证据的心室颤动(VF)、由VF或快室性心动过速(VT,>200次/min)导致的植入式心脏复律除颤器(ICD)放电。结果:在(47.9±46.6)个月的随访期间,共14例HCM患者发生SCA事件。在发生SCA的HCM患者中,J点抬高的检出率为43%(6/14),在无SCA的HCM患者中,J点抬高的检出率为10%(34/331),J波的存在显著增加HCM患者发生SCA风险(OR:5.67,95%CI:2.38~13.50,P<0.001)。在SCA组和无SCA组之间,J点抬高的形态(包括顿挫和光滑延续)和ST段的形态(包括水平/下斜型压低和弓背向下抬高/快速抬高)在所有导联均无统计学差异。结论:HCM患者ECG存在J波与SCA的发生相关。
Objective: To investigate the relationship between J-point elevation (J-wave) and standard of cardiac arrest (SCA) of the standard 12 lead ECG in patients with hypertrophic cardiomyopathy (HCM). Methods: 345 patients with HCM from 7 tertiary level hospitals in Beijing were enrolled, and all subjects were enrolled in resting 12-lead body surface electrocardiogram. The J wave is defined as J point elevation> 0.1 mV above baseline in the inferior leads (II, III and aVF), two or more consecutive leads in the lateral (V4 to V6) or in the superior (I and aVL) leads. SCAs include sudden cardiac death (SCD), documented ventricular fibrillation (VF), implanted cardioverter defibrillators (ICDs) caused by VF or fast ventricular tachycardia (VT,> 200 beats / min) Discharge. RESULTS: During the follow-up of (47.9 ± 46.6) months, a total of 14 HCM patients developed SCA events. The prevalence of J-point elevation was 43% (6/14) in HCM patients with SCA and 10% (34/331) in JMC without SCA, The presence of J wave significantly increased the risk of SCA in HCM patients (OR: 5.67, 95% CI: 2.38-13.50, P <0.001). Between the SCA group and the non-SCA group, the patterns of J-point elevation (including pause and smooth continuation) and the morphology of the ST segment (including horizontal / downhill depression and bow back down / rapid elevation) Lead were no significant difference. Conclusion: The presence of J wave in HCM patients correlated with the occurrence of SCA.