%0 Journal Article
%T S¨ªndromes de la onda J J wave syndromes
%A Annerys M¨¦ndez Rosabal
%J Revista Cubana de Investigaciones Biom£¿£¿dicas
%D 2012
%I ECIMED
%X Se realiz¨® una revisi¨®n sobre los aspectos m¨¢s novedosos y pol¨¦micos de los s¨ªndromes de la onda J, que incluy¨® el s¨ªndrome de repolarizaci¨®n precoz, la fibrilaci¨®n ventricular idiop¨¢tica y la muerte s¨²bita nocturna inexplicable. Se enfatiza en las caracter¨ªsticas electrocardiogr¨¢ficas de estos s¨ªndromes donde se destaca la presencia de un supradesnivel del ST tipo c¨®ncavo con melladuras o empastamiento del mismo. Se profundiza en las bases gen¨¦ticas, a veces com¨²n a todos ellos, en particular la mutaci¨®n SCN5A asociada con el supradesnivel del ST y m¨¢s recientemente la mutaci¨®n S422L-KCNJ8 como causa de alteraci¨®n de los canales I K-ATP, lo cual se asocia con mortalidad arr¨ªtmica card¨ªaca. Se concluye que aunque no todos los pacientes con este s¨ªndrome est¨¦n en riesgo de eventos arr¨ªtmicos o de muerte s¨²bita card¨ªaca, existe un grupo de ellos no despreciable que s¨ª lo est¨¢n, por lo que el gran desaf¨ªo de la comunidad m¨¦dica es desarrollar mejores estrategias de estratificaci¨®n de riesgo y desarrollar tratamientos m¨¢s seguros y eficaces para estos. A review was conducted of the newest and most controversial aspects of J wave syndromes, including early repolarization syndrome, idiopathic ventricular fibrillation and sudden unexplained nocturnal death. Emphasis is made on the ECG features of these syndromes, among them the presence of an upwardly concave ST irregularity with notching or slurring. A detailed analysis is made of genetic bases, which are sometimes common to all syndromes, particularly the SCN5A mutation, associated with the ST upwardly irregularity, and more recently the S422L-KCNJ8 mutation causing the alteration in the lK-ATP channels, associated with arrhythmic cardiac mortality. It is concluded that not all patients with this syndrome are at risk of arrhythmic events or sudden cardiac death, but a significant number of them are. Therefore, a great challenge for the medical community is to develop better risk stratification strategies as well as safer and more effective treatments.
%K onda J
%K repolarizaci¨®n precoz
%K J wave
%K early repolarization
%U http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-03002012000200003