Nussinovitch Udi, Katz Uriel, Nussinovitch Moshe, Nussinovitch Naomi
Department of Internal Medicine B, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Pediatr Cardiol. 2009 Aug;30(6):747-51. doi: 10.1007/s00246-009-9419-0. Epub 2009 Apr 2.
Familial dysautonomia is a worldwide disorder characterized by maldevelopment and dysfunction of the autonomic and sensory systems. Despite major improvements in disease management in recent years, sudden death remains the cause of death in up to 43% of patients. The aim of this study was to evaluate electrocardiographic markers of sudden death in familial dysautonomia. A comparative case series design was used. Electrocardiographic measurements were performed in 13 patients with familial dysautonomia, 7 male and 6 female, aged 9-46 years. QT was measured from all leads and corrected QT (QTc) was calculated with the Bazett formula. QT dispersion (QTd), a marker of arrhythmogenicity, was calculated and corrected for heart rate. Late ventricular potential parameters, predictive of arrhythmias, were calculated as well. Findings were compared to a matched control group using the Mann-Whitney-Wilcoxon test. A prolonged QT interval was noted in 30.7% of patients. Several QT dispersion parameters were significantly abnormal in the study group compared to the controls. All late potential parameters were within normal range in both groups. In conclusion, patients with familial dysautonomia commonly have electrocardiographic abnormalities and may be at a higher risk for adverse cardiac events.
家族性自主神经功能异常是一种全球性疾病,其特征为自主神经系统和感觉系统发育不良及功能障碍。尽管近年来疾病管理有了重大改善,但仍有高达43%的患者死于猝死。本研究的目的是评估家族性自主神经功能异常患者猝死的心电图标志物。采用了比较病例系列设计。对13例家族性自主神经功能异常患者进行了心电图测量,其中男性7例,女性6例,年龄9至46岁。从所有导联测量QT,并使用Bazett公式计算校正QT(QTc)。计算心律失常性标志物QT离散度(QTd)并进行心率校正。还计算了预测心律失常的晚期心室电位参数。使用Mann-Whitney-Wilcoxon检验将结果与匹配的对照组进行比较。30.7%的患者QT间期延长。与对照组相比,研究组的几个QT离散度参数显著异常。两组的所有晚期电位参数均在正常范围内。总之,家族性自主神经功能异常患者通常存在心电图异常,可能发生不良心脏事件的风险更高。