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[杜兴氏肌营养不良症:131例患者的心电图分析]

[Duchenne muscular dystrophy: electrocardiographic analysis of 131 patients].

作者信息

Santos Maria Auxiliadora Bonfim, Costa Francisco de Assis, Travessa Aline Ferreira, Bombig Maria Teresa Nogueira, Fonseca Francisco Helfenstein, Luna Filho Bráulio, Mussi Aurélia, Souza Dilma de, Oliveira Acary de, Povoa Rui

机构信息

Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.

出版信息

Arq Bras Cardiol. 2010 May;94(5):620-4. doi: 10.1590/s0066-782x2010005000024. Epub 2010 Apr 2.

Abstract

BACKGROUND

Cardiac involvement is known to occur in patients with Duchenne muscular dystrophy (DMD). The electrocardiogram (ECG) shows some typical changes in DMD, which makes it a useful test for the diagnosis of cardiac lesion in this disease.

OBJECTIVE

To evaluate the electrocardiographic changes in patients with DMD and to correlate these changes with the age of the population studied.

METHODS

ECG of 131 patients diagnosed with DMD were examined. Several electrocardiographic variables were analyzed, and the patients were divided into two groups - one with and one without changes, for each variable studied. The correlation between the two groups and the age of the patients was analyzed. Garson's criteria were used to establish the electrocardiographic parameters of normality.

RESULTS

ECG was abnormal in 78.6% of the patients. All showed normal sinus rhythm. The following percentages were found for the main variables studied: short PR interval = 18.3%; abnormal R waves in V1 = 29.7%; abnormal Q waves in V6 = 21.3%; abnormal ventricular repolarization = 54.9%; abnormal QS waves in inferior and/or upper lateral wall = 37.4%; conduction disturbances in right bundle branch = 55.7%; prolonged QT C interval = 35.8%, and wide QRS = 23.6%. Unpaired t test was used to establish the correlation between age and the electrocardiographic variables studied in the two groups. Statistically significant differences were found only for the abnormal repolarization variable.

CONCLUSION

Electrocardiographic abnormalities are common in DMD, revealing early cardiac involvement. Only the abnormal ventricular repolarization variable was more frequent, however at a lower age range (p < 0.05).

摘要

背景

已知杜氏肌营养不良症(DMD)患者会出现心脏受累情况。心电图(ECG)在DMD患者中显示出一些典型变化,这使其成为诊断该疾病心脏病变的一项有用检查。

目的

评估DMD患者的心电图变化,并将这些变化与所研究人群的年龄相关联。

方法

对131例确诊为DMD的患者进行心电图检查。分析了多个心电图变量,并将患者分为两组——对于每个研究变量,一组有变化,一组无变化。分析两组与患者年龄之间的相关性。采用加森标准来确定正常心电图参数。

结果

78.6%的患者心电图异常。所有患者均表现为正常窦性心律。所研究的主要变量出现以下百分比:PR间期缩短 = 18.3%;V1导联R波异常 = 29.7%;V6导联Q波异常 = 21.3%;心室复极异常 = 54.9%;下壁和/或上侧壁QS波异常 = 37.4%;右束支传导障碍 = 55.7%;QTc间期延长 = 35.8%,QRS波增宽 = 23.6%。采用非配对t检验来确定年龄与两组中所研究的心电图变量之间的相关性。仅在复极异常变量中发现有统计学意义的差异。

结论

心电图异常在DMD患者中很常见,提示早期心脏受累。然而,只有心室复极异常变量更为常见,但出现在较低年龄范围(p < 0.05)。

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