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ID 53013
フルテキストURL
著者
Tokioka, Koji Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Cardiovasc Med
Kusano, Kengo F. Natl Cerebral & Cardiovasc Ctr, Dept Cardiovasc Med
Morita, Hiroshi Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Cardiovasc Med
Miura, Daiji Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Cardiovasc Med
Nishii, Nobuhiro Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Cardiovasc Med
Nagase, Satoshi Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Cardiovasc Med
Nakamura, Kazufumi Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Cardiovasc Med
Kohno, Kunihisa Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Cardiovasc Med
Ito, Hiroshi Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Cardiovasc Med
Ohe, Tohru Sakakibara Heart Inst Okayama
抄録
Objectives This study aimed to determine the usefulness of the combination of several electrocardiographic markers on risk assessment of ventricular fibrillation (VF) in patients with Brugada syndrome (BrS). Background Detection of high-/low-risk BrS patients using a noninvasive method is an important issue in the clinical setting. Several electrocardiographic markers related to depolarization and repolarization abnormalities have been reported, but the relationship and usefulness of these parameters in VF events are unclear. Methods Baseline characteristics of 246 consecutive patients (236 men; mean age, 47.6 +/- 13.6 years) with a Brugada-type electrocardiogram, including 13 patients with a history of VF and 40 patients with a history of syncope episodes, were retrospectively analyzed. During the mean follow-up period of 45.1 months, VF in 23 patients and sudden cardiac death (SCD) in 1 patient were observed. Clinical/ genetic and electrocardiographic parameters were compared with VF/SCD events. Results On univariate analysis, a history of VF and syncope episodes, paroxysmal atrial fibrillation, spontaneous type 1 pattern in the precordial leads, and electrocardiographic markers of depolarization abnormalities (QRS duration >= 120 ms, and fragmented QRS [f-QRS]) and those of repolarization abnormalities (inferolateral early repolarization [ER] pattern and QT prolongation) were associated with later cardiac events. On multivariable analysis, a history of VF and syncope episodes, inferolateral ER pattern, and f-QRS were independent predictors of documented VF and SCD (odds ratios: 19.61, 28.57, 2.87, and 5.21, respectively; p < 0.05). Kaplan-Meier curves showed that the presence/ absence of inferolateral ER and f-QRS predicted a worse/better prognosis (log-rank test, p < 0.01). Conclusions The combination of depolarization and repolarization abnormalities in BrS is associated with later VF events. The combination of these abnormalities is useful for detecting high-and low-risk BrS patients.
キーワード
Brugada syndrome
early repolarization
fragmented QRS
noninvasive risk assessment
ventricular fibrillation
発行日
2014-05-27
出版物タイトル
Journal of the American College of Cardiology
63巻
20号
開始ページ
2131
終了ページ
2138
ISSN
0735-1097
資料タイプ
学術雑誌論文
関連URL
http://ousar.lib.okayama-u.ac.jp/metadata/52969
言語
English
著作権者
(c) 2014 by the American College of Cardiology Foundation
論文のバージョン
author
査読
有り
DOI
Web of Sience KeyUT