Author + information
- Received December 4, 2017
- Revision received January 29, 2018
- Accepted February 1, 2018
- Published online June 18, 2018.
- Satoshi Kawada, MDa,
- Hiroshi Morita, MD, PhDb,∗ (, )
- Charles Antzelevitch, PhDc,
- Yoshimasa Morimoto, MDa,
- Koji Nakagawa, MD, PhDa,
- Atsuyuki Watanabe, MD, PhDa,
- Nobuhiro Nishii, MD, PhDb,
- Kazufumi Nakamura, MD, PhDa and
- Hiroshi Ito, MD, PhDa
- aDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
- bDepartment of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
- cLankenau Institute for Medical Research, Wynnewood, Pennsylvania
- ↵∗Address for correspondence:
Dr. Hiroshi Morita, Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan.
Objectives The principal objective was to perform an initial test of the Shanghai Brugada Scoring System. Diagnosis of probable and/or definite Brugada syndrome (BrS), possible BrS, and nondiagnostic outcomes were assigned scores of ≥3.5, 2 to 3, and <2 points, respectively. The proposed score system was based on the available published reports and on weighted coefficients derived from limited datasets, with the understanding that these recommendations would need to undergo continuing validation.
Background The 2016 HRS/EHRA/APHRS/SOLAECE J-Wave Syndrome Consensus Report proposed a scoring system for diagnosis of BrS that takes into account electrocardiographic recordings, genetic results, clinical characteristics, and family history.
Methods The patient population consisted of 393 patients evaluated at our hospital for BrS (271 asymptomatic, 99 with syncope, and 23 with ventricular fibrillation [VF]) between 1996 and 2016. Subjects were classified into 4 groups: group A with a score of ≤3.0 points (n = 45); group B with a score of 3.5 points (n = 186); group C with a score of 4.0 to 5.0 points (n = 81); and group D with a score of ≥5.5 points (n = 81).
Results A total of 348 (88%) patients had probable and/or definite BrS, and 81 (20%) had a score ≥5.5. During a follow-up of 97.3 months (range: 39.7 to 142.1 months), 43 patients experienced VF. Significant differences were seen among the 4 groups (p = 0.01). A malignant arrhythmic event did not occur in any patient with possible or nondiagnostic BrS.
Conclusions This study provided validation for the use of the Shanghai Score System for the diagnosis and risk stratification of patients with BrS.
Drs. Morita and Nishii are affiliated with the endowed department by Japan Medtronic Inc. Dr. Morita was supported by JSPS KAKENHI (15K09082), the Tailor-made Medical Treatment Program with the BioBank Japan Project from the Japan Agency for Medical Research and Development, AMED (JP17km0405109), and a grant from the Suzuken Memorial Foundation (M22-031-4). Dr. Nishii was supported by JSPS KAKENHI (16K09437).
Dr. Antzelevitch was supported by the National Institutes of Health (HL47678) and a grant from Pharmacyclics.
All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
All authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Clinical Electrophysiology author instructions page.
- Received December 4, 2017.
- Revision received January 29, 2018.
- Accepted February 1, 2018.
- 2018 American College of Cardiology Foundation
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