nach oben

Erschienen in:

01.01.2015 | Original Article

Electrocardiographic J waves are associated with right ventricular morphology and function: evaluation by cardiac magnetic resonance imaging

verfasst von: Takahiro Takeuchi, Takeshi Tomita, Kouji Yoshie, Hirohumi Hioki, Yasutaka Oguchi, Takashi Miura, Souichirou Ebisawa, Hirohiko Motoki, Ayako Okada, Kazunori Aizawa, Atsushi Izawa, Yusuke Miyashita, Jun Koyama, Uichi Ikeda

Erschienen in: Heart and Vessels | Ausgabe 1/2015

Einloggen, um Zugang zu erhalten

Abstract

We assessed the relationship between J waves and the ventricular morphology and function using cardiac magnetic resonance imaging (MRI). The 12-lead electrocardiograms (ECGs) of 105 consecutive patients who underwent cardiac MRI were reviewed, and those with signs of arrhythmogenic right ventricular cardiomyopathy, complete left bundle branch block, complete right bundle branch block, or chronic atrial fibrillation, where the J wave is difficult to distinguish, were excluded. The ECGs of the remaining 68 patients were analyzed for the presence of J waves. Ventricular morphologic abnormalities were identified on MRI, based on the largest short-axis diameter in the right and left ventricles (d-RV_max/d-LV_max), the area (a-RV_max/a-LV_max), and the ratio RV/LV_max. The percentage contraction of the RV (PC-RV) was used as a measure of ventricular function. Thirty-two patients (47.0 %) had J waves defined as QRS-ST junction elevation >0.1 mV from baseline in the inferior/lateral leads (J group; 56 ± 15 years; 19 males). Thirty-six patients (53.0 %) did not present J waves (NJ group; 58 ± 15 years; 27 males). The d-RV_max and a-RV_max in the J group were larger than those in the NJ group (41 ± 5.2 vs 36 ± 6.6 mm, P = 0.002 and 14 ± 2.9 vs 12 ± 3.4 cm², P = 0.022, respectively). The RV/LV_max ratio in the J group was larger than that in the NJ group (0.83 ± 0.15 vs 0.68 ± 0.15, P < 0.001). The PC-RV in the J group was smaller than that in the NJ group (0.28 ± 0.14 vs 0.36 ± 0.15, P = 0.013). J-wave amplitude was correlated positively with d-RV_max (P = 0.010) and negatively with PC-RV (P = 0.005). These results suggested that J waves are associated with right ventricular morphologic and functional abnormalities.

Haissaguerre M, Derval N, Sacher F, Jesel L, Deisenhofer I, de Roy L, Pasquie JL, Nogami A, Babuty D, Yli-Mayry S, De Chillou C, Scanu P, Mabo P, Matsuo S, Probst V, Le Scouarnec S, Defaye P, Schlaepfer J, Rostock T, Lacroix D, Lamaison D, Lavergne T, Aizawa Y, Englund A, Anselme F, O’Neill M, Hocini M, Lim KT, Knecht S, Veenhuyzen GD, Bordachar P, Chauvin M, Jais P, Coureau G, Chene G, Klein GJ, Clementy J (2008) Sudden cardiac arrest associated with early repolarization. N Engl J Med 358:2016–2023PubMedCrossRef

Haruta D, Matsuo K, Tsuneto A, Ichimaru S, Hida A, Sera N, Imaizumi M, Nakashima E, Maemura K, Akahoshi M (2011) Incidence and prognostic value of early repolarization pattern in the 12-lead electrocardiogram. Circulation 123:2931–2937PubMedCrossRef

Olson KA, Viera AJ, Soliman EZ, Crow RS, Rosamond WD (2011) Long-term prognosis associated with J-point elevation in a large middle-aged biracial cohort: the ARIC study. Eur Heart J 32:3098–3106PubMedCentralPubMedCrossRef

Rosso R, Glikson E, Belhassen B, Katz A, Halkin A, Steinvil A, Viskin S (2011) Distinguishing “benign” from “malignant early repolarization”: the value of the ST-segment morphology. Heart Rhythm 9:225–229PubMedCrossRef

Tikkanen JT, Anttonen O, Junttila MJ, Aro AL, Kerola T, Rissanen HA, Reunanen A, Huikuri HV (2009) Long-term outcome associated with early repolarization on electrocardiography. N Engl J Med 361:2529–2537PubMedCrossRef

Haissaguerre M, Sacher F, Nogami A, Komiya N, Bernard A, Probst V, Yli-Mayry S, Defaye P, Aizawa Y, Frank R, Mantovan R, Cappato R, Wolpert C, Leenhardt A, de Roy L, Heidbuchel H, Deisenhofer I, Arentz T, Pasquie JL, Weerasooriya R, Hocini M, Jais P, Derval N, Bordachar P, Clementy J (2009) Characteristics of recurrent ventricular fibrillation associated with inferolateral early repolarization role of drug therapy. J Am Coll Cardiol 53:612–619PubMedCrossRef

Rosso R, Adler A, Halkin A, Viskin S (2011) Risk of sudden death among young individuals with J waves and early repolarization: putting the evidence into perspective. Heart Rhythm 8:923–929PubMedCrossRef

Rosso R, Kogan E, Belhassen B, Rozovski U, Scheinman MM, Zeltser D, Halkin A, Steinvil A, Heller K, Glikson M, Katz A, Viskin S (2008) J-point elevation in survivors of primary ventricular fibrillation and matched control subjects: incidence and clinical significance. J Am Coll Cardiol 52:1231–1238PubMedCrossRef

Brugada P, Brugada J (1992) Right bundle branch block, persistent ST segment elevation and sudden cardiac death: a distinct clinical and electrocardiographic syndrome. A multicenter report. J Am Coll Cardiol 20:1391–1396PubMedCrossRef

10.

Kalla H, Yan GX, Marinchak R (2000) Ventricular fibrillation in a patient with prominent J (Osborn) waves and ST segment elevation in the inferior electrocardiographic leads: a Brugada syndrome variant? J Cardiovasc Electrophysiol 11:95–98PubMedCrossRef

11.

Kamakura S, Ohe T, Nakazawa K, Aizawa Y, Shimizu A, Horie M, Ogawa S, Okumura K, Tsuchihashi K, Sugi K, Makita N, Hagiwara N, Inoue H, Atarashi H, Aihara N, Shimizu W, Kurita T, Suyama K, Noda T, Satomi K, Okamura H, Tomoike H (2009) Long-term prognosis of probands with Brugada-pattern ST-elevation in leads V1–V3. Circ Arrhythm Electrophysiol 2:495–503PubMedCrossRef

12.

Sarkozy A, Chierchia GB, Paparella G, Boussy T, De Asmundis C, Roos M, Henkens S, Kaufman L, Buyl R, Brugada R, Brugada J, Brugada P (2009) Inferior and lateral electrocardiographic repolarization abnormalities in Brugada syndrome. Circ Arrhythm Electrophysiol 2:154–161PubMedCrossRef

13.

Gussak I, Antzelevitch C (2000) Early repolarization syndrome: clinical characteristics and possible cellular and ionic mechanisms. J Electrocardiol 33:299–309PubMedCrossRef

14.

Mehta M, Jain AC, Mehta A (1999) Early repolarization. Clin Cardiol 22:59–65PubMedCrossRef

15.

Yan GX, Antzelevitch C (1996) Cellular basis for the electrocardiographic J wave. Circulation 93:372–379PubMedCrossRef

16.

Watanabe H, Nogami A, Ohkubo K, Kawata H, Hayashi Y, Ishikawa T, Makiyama T, Nagao S, Yagihara N, Takehara N, Kawamura Y, Sato A, Okamura K, Hosaka Y, Sato M, Fukae S, Chinushi M, Oda H, Okabe M, Kimura A, Maemura K, Watanabe I, Kamakura S, Horie M, Aizawa Y, Shimizu W, Makita N (2011) Electrocardiographic characteristics and SCN5A mutations in idiopathic ventricular fibrillation associated with early repolarization. Circ Arrhythm Electrophysiol 4:874–881PubMedCrossRef

17.

Postema PG, van Dessel PF, Kors JA, Linnenbank AC, van Herpen G, Ritsema van Eck HJ, van Geloven N, de Bakker JM, Wilde AA, Tan HL (2010) Local depolarization abnormalities are the dominant pathophysiologic mechanism for type 1 electrocardiogram in Brugada syndrome a study of electrocardiograms, vectorcardiograms, and body surface potential maps during ajmaline provocation. J Am Coll Cardiol 55:789–797PubMedCrossRef

18.

Papavassiliu T, Wolpert C, Fluchter S, Schimpf R, Neff W, Haase KK, Duber C, Borggrefe M (2004) Magnetic resonance imaging findings in patients with Brugada syndrome. J Cardiovasc Electrophysiol 15:1133–1138PubMedCrossRef

19.

Takagi M, Aihara N, Kuribayashi S, Taguchi A, Kurita T, Suyama K, Kamakura S, Takamiya M (2003) Abnormal response to sodium channel blockers in patients with Brugada syndrome: augmented localised wall motion abnormalities in the right ventricular outflow tract region detected by electron beam computed tomography. Heart 89:169–174PubMedCentralPubMedCrossRef

20.

Takagi M, Aihara N, Kuribayashi S, Taguchi A, Shimizu W, Kurita T, Suyama K, Kamakura S, Hamada S, Takamiya M (2001) Localized right ventricular morphological abnormalities detected by electron-beam computed tomography represent arrhythmogenic substrates in patients with the Brugada syndrome. Eur Heart J 22:1032–1041PubMedCrossRef

21.

Catalano O, Antonaci S, Moro G, Mussida M, Frascaroli M, Baldi M, Cobelli F, Baiardi P, Nastoli J, Bloise R, Monteforte N, Napolitano C, Priori SG (2009) Magnetic resonance investigations in Brugada syndrome reveal unexpectedly high rate of structural abnormalities. Eur Heart J 30:2241–2248PubMedCrossRef

22.

Sato Y, Kato K, Hashimoto M, Akiyama H, Matsumoto N, Takase H, Ogawa K, Sakamaki T, Yagi H, Kanmatsuse K (1996) Localized right ventricular structural abnormalities in patients with idiopathic ventricular fibrillation: magnetic resonance imaging study. Heart Vessels 11:100–103PubMedCrossRef

23.

Antzelevitch C, Yan GX (2010) J wave syndromes. Heart Rhythm 7:549–558PubMedCentralPubMedCrossRef

24.

Franzen E, Mangold S, Erz G, Claussen CD, Niess AM, Kramer U, Burgstahler C (2012) Comparison of morphological and functional adaptations of the heart in highly trained triathletes and long-distance runners using cardiac magnetic resonance imaging. Heart Vessels. doi:10.1007/s00380-012-0289-7 PubMed

25.

Lee N, Das A, Banerjee RK, Gottliebson WM (2013) Comparison of stroke work between repaired tetralogy of Fallot and normal right ventricular physiologies. Heart Vessels 28:76–85PubMedCrossRef

26.

Antzelevitch C, Brugada P, Borggrefe M, Brugada J, Brugada R, Corrado D, Gussak I, LeMarec H, Nademanee K, Perez Riera AR, Shimizu W, Schulze-Bahr E, Tan H, Wilde A (2005) Brugada syndrome: report of the second consensus conference: endorsed by the Heart Rhythm Society and the European Heart Rhythm Association. Circulation 111:659–670PubMedCrossRef

27.

Morita H, Kusano KF, Miura D, Nagase S, Nakamura K, Morita ST, Ohe T, Zipes DP, Wu J (2008) Fragmented QRS as a marker of conduction abnormality and a predictor of prognosis of Brugada syndrome. Circulation 118:1697–1704PubMedCrossRef

28.

Lambiase PD, Ahmed AK, Ciaccio EJ, Brugada R, Lizotte E, Chaubey S, Ben-Simon R, Chow AW, Lowe MD, McKenna WJ (2009) High-density substrate mapping in Brugada syndrome: combined role of conduction and repolarization heterogeneities in arrhythmogenesis. Circulation 120:106–117

29.

Abe A, Ikeda T, Tsukada T, Ishiguro H, Miwa Y, Miyakoshi M, Mera H, Yusu S, Yoshino H (2010) Circadian variation of late potentials in idiopathic ventricular fibrillation associated with J waves: insights into alternative pathophysiology and risk stratification. Heart Rhythm 7:675–682PubMedCrossRef

30.

Aizawa Y, Sato A, Watanabe H, Chinushi M, Furushima H, Horie M, Kaneko Y, Imaizumi T, Okubo K, Watanabe I, Shinozaki T, Fukuda K, Joo K, Haissaguerre M (2012) Dynamicity of the J-wave in idiopathic ventricular fibrillation with a special reference to pause-dependent augmentation of the J-wave. J Am Coll Cardiol 59:1948–1953PubMedCrossRef

31.

Aizawa Y, Tamura M, Chinushi M, Naitoh N, Uchiyama H, Kusano Y, Hosono H, Shibata A (1993) Idiopathic ventricular fibrillation and bradycardia-dependent intraventricular block. Am Heart J 126:1473–1474PubMedCrossRef

32.

Maruyama M, Atarashi H, Ino T, Kishida H (2002) Osborn waves associated with ventricular fibrillation in a patient with vasospastic angina. J Cardiovasc Electrophysiol 13:486–489PubMedCrossRef

33.

Sahara M, Sagara K, Yamashita T, Abe T, Kirigaya H, Nakada M, Iinuma H, Fu LT, Watanabe H (2002) J wave and ST segment elevation in the inferior leads: a latent type of variant Brugada syndrome? Jpn Heart J 43:55–60PubMedCrossRef

34.

McKenna WJ, Thiene G, Nava A, Fontaliran F, Blomstrom-Lundqvist C, Fontaine G, Camerini F (1994) Diagnosis of arrhythmogenic right ventricular dysplasia/cardiomyopathy. Task Force of the Working Group Myocardial and Pericardial Disease of the European Society of Cardiology and of the Scientific Council on Cardiomyopathies of the International Society and Federation of Cardiology. Br Heart J 71:215–218PubMedCentralPubMedCrossRef

Titel: Electrocardiographic J waves are associated with right ventricular morphology and function: evaluation by cardiac magnetic resonance imaging
verfasst von: Takahiro Takeuchi
Takeshi Tomita
Kouji Yoshie
Hirohumi Hioki
Yasutaka Oguchi
Takashi Miura
Souichirou Ebisawa
Hirohiko Motoki
Ayako Okada
Kazunori Aizawa
Atsushi Izawa
Yusuke Miyashita
Jun Koyama
Uichi Ikeda
Publikationsdatum: 01.01.2015
Verlag: Springer Japan
Erschienen in: Heart and Vessels / Ausgabe 1/2015
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI: https://doi.org/10.1007/s00380-013-0439-6

Neu im Fachgebiet Kardiologie

19.04.2024 | Vorhofflimmern | Nachrichten

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Electrocardiographic J waves are associated with right ventricular morphology and function: evaluation by cardiac magnetic resonance imaging

Abstract

Neu im Fachgebiet Kardiologie

Parodontalbehandlung verbessert Prognose bei Katheterablation

Antihypertensiva schützen auch alte Menschen noch vor Demenz

Sind Betablocker auch für ältere herzschwache Personen nützlich?

Stillende Frauen haben geringeres kardiovaskuläres Risiko

Update Kardiologie

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 1/2015

Continuous positive airway pressure treatment improves cardiovascular outcomes in elderly patients with cardiovascular disease and obstructive sleep apnea

Fasudil improves short-term echocardiographic parameters of diastolic function in patients with type 2 diabetes with preserved left ventricular ejection fraction: a pilot study

Natural history of low-intensity neointimal tissue after an everolimus-eluting stent implantation: a serial observation with optical coherence tomography

The clinical characteristics of sudden cardiac arrest in asymptomatic patients with congenital heart disease

Association of intramural fat deposition in the interatrial septum with focal atrial tachyarrhythmias originating near the atrioventricular node

Role of non-electrocardiogram-gated contrast-enhanced computed tomography in the diagnosis of acute coronary syndrome

Neu im Fachgebiet Kardiologie

Parodontalbehandlung verbessert Prognose bei Katheterablation

Antihypertensiva schützen auch alte Menschen noch vor Demenz

Sind Betablocker auch für ältere herzschwache Personen nützlich?

Stillende Frauen haben geringeres kardiovaskuläres Risiko

Update Kardiologie