English Kate M, Gibbs John L
Department of Congenital Cardiology, Yorkshire Heart Centre, Leeds General Infirmary, Leeds LS1 3EX, UK.
Dev Med Child Neurol. 2006 Mar;48(3):231-5. doi: 10.1017/S0012162206000491.
Dilated cardiomyopathy, hypertrophic cardiomyopathy, and cardiac rhythm disturbances are important features of certain neuromuscular disorders in children, adolescents, and young adults. This article summarizes the cardiac features seen in patients with Duchenne muscular dystrophy, Becker muscular dystrophy, myotonic dystrophy, Friedreich's ataxia, and Emery-Dreifuss muscular dystrophy. The optimal management of these cardiac features remains contentious, but increasingly these patients are referred for routine cardiological assessment in the absence of symptoms. This article examines the value of routine screening and drug interventions for cardiac complications in asymptomatic and symptomatic individuals with neuromuscular disorders. We recommend a pragmatic approach, actively looking for cardiac conditions which will benefit from early intervention, but avoiding routine screening for asymptomatic conditions in which there is no evidence of benefit from early intervention.
扩张型心肌病、肥厚型心肌病和心律失常是儿童、青少年及青年某些神经肌肉疾病的重要特征。本文总结了杜氏肌营养不良症、贝克肌营养不良症、强直性肌营养不良症、弗里德赖希共济失调症和埃默里-德赖富斯肌营养不良症患者的心脏特征。这些心脏特征的最佳管理仍存在争议，但越来越多此类患者在无症状时就被转诊进行常规心脏评估。本文探讨了对无症状和有症状神经肌肉疾病患者进行心脏并发症常规筛查和药物干预的价值。我们建议采取务实的方法，积极寻找可从早期干预中获益的心脏疾病，但避免对无证据表明早期干预有益的无症状疾病进行常规筛查。
