背景:在Brugada综合征患者中,心肌纤维化可以通过心外膜活检或心脏磁共振成像(CMR)和晚期钆增强(LGE)来识别。然而,早期复极综合征(ERS)患者的心肌改变尚不清楚.
目的:在CMR中使用LGE研究ERS患者心肌纤维化的存在。
方法:我们回顾性评估了20例ERS患者,所有这些人在相邻的两条导线中都表现出J波。J波的位置分类为隔膜(V1-V2),前(V3-V4),横向(I,aVL,V5-V6),劣等(II,III,aVF),或后部(V7-V9)区域。为了比较LGE在CMR和J波中的分布,左心室(LV)的短轴视图的部分被分类为位于隔膜,前,横向,劣等,和后部区域。
结果:总体而言,85%的ERS患者显示LGE,在隔膜和后部区域更为普遍,其次是下部和横向区域。61%的LV区域同时存在或不存在J波和LGE,而38%的人观察到J波和LGE的分布不一致。LGE在隔膜中最常见(75%),其中它在J波中的反射可能不太健壮。LGE的出现与症状无关,电风暴,或随访期间发生VF。
结论:LGE在ERS患者中很常见,J波和LGE的分布在大约60%的LV区域重合。
BACKGROUND: In patients with Brugada syndrome, myocardial fibrosis can be identified through epicardial biopsy or cardiac magnetic resonance (CMR) imaging with late gadolinium enhancement (LGE). However, the myocardial alterations in patients with early repolarization syndrome (ERS) remain poorly elucidated.
OBJECTIVE: The objective of this study was to investigate the presence of myocardial fibrosis in patients with ERS by LGE in CMR.
METHODS: We retrospectively evaluated 20 patients with ERS, all of whom exhibited J waves in the contiguous 2 leads. The location of J waves was classified as in the septum (V1-V2), anterior (V3-V4), lateral (I, aVL, V5-V6), inferior (II, III, aVF), or posterior (V7-V9) regions. To compare the distribution of LGE on CMR imaging with J waves, sections on short-axis view of the left ventricle (LV) were categorized as located in the septum, anterior, lateral, inferior, and posterior regions.
RESULTS: Overall, 85% of ERS patients displayed LGE, which was more prevalent in the septum and posterior regions, followed by the inferior and lateral regions. The presence or absence of J waves and LGE coincided in 61% of LV areas, whereas discordance between the distributions of J waves and LGE was observed in 38%. LGE was most frequent in the septum (75%), where its reflection in J waves may be less robust. The appearance of LGE was not associated with symptoms, electrical storm, or ventricular fibrillation occurrence during follow-up.
CONCLUSIONS: LGE is common in patients with ERS, and the distribution of J waves and LGE coincides in approximately 60% of LV areas.