ABSTRACT
Aims: Brugada syndrome is characterised by ST segment elevation in right precordial leads and associated sometimes with idiopathic ventricular fibrillation leading to sudden cardiac death. Although ECG recording at higher intercostal space unmasks Brugada syndrome, the vectorcardiographic (VCG) mechanisms of this unmasking remain unknown. Place and Duration of Study: Noninvasive ECG laboratory of Heart Center, Kyushu University Hospital, Fukuoka, Japan, from November 2013 to April 2015. Methodology: Twelve-lead digital ECG was recorded at standard (4th) and higher (3rd and 2nd) intercostal space in 5 patients with Brugada syndrome. The ECG data were transformed automatically to the VCG data based on the corrected three orthogonal Frank leads (X, Y and Z) and three vector loops of P, QRS and T waves were constructed and projected to the three (horizontal, frontal and right sagittal) orthogonal planes. Results: ST elevation in the standard right precordial leads (V1 to V3) was augmented by the 12-lead ECG recorded at higher intercostal space. Saddle back ST elevation was often converted to coved type ST elevation by this invent. QRS loop was open in all 5 patients, and the maximum J-point vector showed right anterosuperior direction, whereas T loop showed left anteroinferior direction. The J-point vector faced toward and the maximum T vector faced backward the right precordial ECG electrodes, which was accentuated by shifting them to the higher intercostal space. Conclusion: Unmasking of Brugada ECG was explained well even in this small-sample study by the spatial relationship between the orientations of ST-T vector and the standard right precordial ECG electrodes positioned at the higher intercostal space.
ABSTRACT
Aims: Plasmalogens are unique phospholipid of biological membrane and is considered to play a potent role of intrinsic antioxidant. Atherosclerosis is associated with oxidative stress, but the correlation between plasmalogens and atherosclerosis is debatable. Therefore, this study aimed to assess the plasma and erythrocyte membrane phospholipids profile in patients with coronary heart diseases (CHD) undergoing percutaneous coronary intervention (PCI). Place and Duration of the Study: Vascular laboratory of Heart Center, Kyushu University Hospital, Fukuoka, Japan, from February to August 2016. Methodology: The plasma concentrations and erythrocyte membrane contents of phospholipids were quantified in patients with CHD (n = 30, group A) and age-matched controls (n = 38, group B) using high-performance liquid chromatography with evaporative light scattering detection method. Results: Plasma concentrations of plasmalogens in group A were significantly lower than those in group B. Similar findings were obtained from relative contents of plasmalogens in the erythrocyte membrane. Multiple regression models for plasmalogens yielded phospholipids other than plasmalogen as determinants of plasmalogens. Conclusions: This cross-sectional study indicated that plasma and erythrocyte membrane plasmalogens are reduced in patients with CHD undergoing PCI. Further longitudinal studies are required to elucidate the clinical role of intrinsic plasmalogens as a laboratory marker of oxidative stress and extrinsic plasmalogens as a novel therapy for atherosclerosis.