Department of Neurology, Leiden University Medical Centre, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
J Neurol. 2010 Mar;257(3):447-51. doi: 10.1007/s00415-009-5350-9. Epub 2009 Oct 8.
The purpose of this study was to explore the prevalence and nature of cardiac abnormalities in sporadic inclusion body myositis (sIBM). Fifty-one sIBM patients were cross-sectionally studied using history-taking, physical examination, measurements of serum creatine kinase activity, the MB fraction (CK-MB), cardiac troponin T (cTnT) and I (cTnI), a 12-lead electrocardiogram (ECG) and 2-dimensional echocardiography. Present cardiac history was abnormal in 12 (24%) out of 51 patients, 12 (24%) patients had abnormalities on ECG, mostly aspecific, and in 12 (24%) patients the echocardiograph showed abnormalities. Elevated CK-MB was present in 42 (82%) patients and 40 (78%) had an elevated cTnT in the absence of acute cardiac pathology. In contrast, in one patient (2%) cTnI was elevated. There was no apparent association between elevated biomarkers, ECG or echocardiographic abnormalities. The prevalence of cardiac abnormalities in sIBM does not seem to be higher than would be expected in these elderly patients. Elevated CK-MB and cTnT levels are common, in contrast to cTnI, but do not reflect cardiac pathology.
本研究旨在探讨散发性包涵体肌炎(sIBM)患者中心脏异常的发生率和特征。通过病史询问、体格检查、血清肌酸激酶(CK)活性、MB 片段(CK-MB)、心肌肌钙蛋白 T(cTnT)和 I(cTnI)、12 导联心电图(ECG)和二维超声心动图对 51 例 sIBM 患者进行了横断面研究。51 例患者中,有 12 例(24%)存在现患心脏病史异常,12 例(24%)心电图异常,多为非特异性,12 例(24%)超声心动图异常。42 例(82%)患者 CK-MB 升高,40 例(78%)患者 cTnT 升高,无急性心脏病变。相比之下,1 例(2%)患者 cTnI 升高。升高的生物标志物、心电图或超声心动图异常之间似乎没有明显关联。sIBM 患者中心脏异常的发生率似乎并不高于这些老年患者的预期发生率。与 cTnI 相比,CK-MB 和 cTnT 水平升高更为常见,但不反映心脏病理。