Sakata C, Yamada H, Sunohara N, Arahata K, Nonaka I
Department of Neurology, National Center of Neurology and Psychiatry.
Rinsho Shinkeigaku. 1990 Sep;30(9):952-5.
In 6 patients with dystrophin-verified Becker muscular dystrophy (BMD), 3 patients had dilated cardiomyopathy (DCM group). The other 3 patients (non-DCM group) also had ECG abnormalities including incomplete right bundle branch block, left ventricular enlargement and intraventricular conduction defect. Between DCM and non-DCM group, there was no prominent difference in ages at onset, mean duration and severity of muscular weakness. Serum CK levels, and molecular weight and amount of dystrophin also showed no significant difference between two groups. On reviewing 14 BMD patients, including 3 present patients with cardiomyopathy, the cardiac symptoms appeared from 4 to 41 years, averaging 17.1 years of age. The mean duration of muscle symptoms was 9 years, ranging from 0 to 33 years. There was no correlation between severity of muscle weakness and cardiomyopathy. Six patients died of heart failure and 3 received cardiac transplantation. Thus there was no characteristic clinical feature in BMD patients with cardiomyopathy except for very poor prognosis. Since the myocardial involvement is not related with clinical severity and duration of the disease, careful observation for cardiac function should be carried out in all BMD patients even in the early stage of muscle weakness.
在6例经肌营养不良蛋白证实的贝克型肌营养不良症(BMD)患者中,3例患有扩张型心肌病(DCM组)。另外3例患者(非DCM组)也有心电图异常,包括不完全性右束支传导阻滞、左心室扩大和室内传导缺陷。DCM组和非DCM组在发病年龄、平均病程和肌无力严重程度方面没有显著差异。两组之间的血清肌酸激酶(CK)水平、肌营养不良蛋白的分子量和含量也没有显著差异。在回顾包括3例目前患有心肌病的患者在内的14例BMD患者时,心脏症状出现在4至41岁之间,平均年龄为17.1岁。肌肉症状的平均病程为9年,范围为0至33年。肌无力严重程度与心肌病之间没有相关性。6例患者死于心力衰竭,3例接受了心脏移植。因此,除了预后极差外,BMD合并心肌病的患者没有特征性的临床特征。由于心肌受累与疾病的临床严重程度和病程无关,即使在肌无力的早期阶段,所有BMD患者也应仔细观察心脏功能。