Stöllberger Claudia, Gerger Daniel, Wegner Christian, Finsterer Josef
Krankenanstalt Rudolfstiftung, Wien, Austria.
Ann Noninvasive Electrocardiol. 2013 May;18(3):251-5. doi: 10.1111/anec.12053.
Left ventricular hypertrabeculation/noncompaction (LVHT) is frequently associated with neuromuscular disorders (NMDs) and electrocardiographic (ECG) abnormalities. Quantitative ECG-measures (QEMs) are risk markers for mortality in cardiomyopathies. We measured QEMs in the ECGs in LVHT patients with and without NMDs.
Included were patients in whom (a) LVHT was diagnosed between 1995 and 2011 and (b) baseline ECG recordings were available. All underwent a clinical examination and were invited for a neurological investigation. QRS duration, QT, QTc and PR intervals were analyzed. Survival status was assessed in June 2011.
In 141 patients (mean age 54 years, 49 females) QRS duration ranged from 40 to 200 ms, a QRS duration >120 ms was found in 19% and was associated with increased age, heart failure, left ventricular dilatation and systolic dysfunction (P < 0.001). QT intervals ranged from 240 to 600 ms. The QTc intervals ranged from 302 to 612 ms, a QTc interval >440 ms was found in 38% and was associated with left ventricular dilatation and systolic dysfunction (P < 0.001). PR intervals ranged from 90 to 360 ms, a PR interval >200 ms was found in 16% and associated with left ventricular dilatation (P < 0.01). No QEM differences were found in 86 patients with and 13 without NMD. During 59 months follow-up 45 patients died. QEMs were no mortality predictors, whereas multivariate analysis identified heart failure (P < 0.01), atrial fibrillation (P < 0.01) and diabetes mellitus (P < 0.05) as mortality predictors.
Prolonged QRS complexes, PR and QTc intervals in LVHT are associated with heart failure and left ventricular dilatation, but not with NMD. The prognostic role of QEMs in LVHT needs further investigations in larger series.
左心室致密化不全（LVHT）常与神经肌肉疾病（NMDs）和心电图（ECG）异常相关。心电图定量测量指标（QEMs）是心肌病患者死亡的风险标志物。我们对合并或不合并NMDs的LVHT患者的心电图QEMs进行了测量。
纳入1995年至2011年间诊断为（a）LVHT且（b）有基线心电图记录的患者。所有患者均接受了临床检查，并被邀请进行神经学检查。分析了QRS时限、QT、QTc和PR间期。于2011年6月评估生存状况。
141例患者（平均年龄54岁，49例女性）的QRS时限为40至200毫秒，19%的患者QRS时限>120毫秒，且与年龄增加、心力衰竭、左心室扩张和收缩功能障碍相关（P<0.001）。QT间期为240至600毫秒。QTc间期为302至612毫秒，38%的患者QTc间期>440毫秒，且与左心室扩张和收缩功能障碍相关（P<0.001）。PR间期为90至360毫秒，16%的患者PR间期>200毫秒，且与左心室扩张相关（P<0.01）。86例合并NMDs的患者和13例未合并NMDs的患者在QEMs方面未发现差异。在59个月的随访期间，45例患者死亡。QEMs不是死亡的预测指标，而多变量分析确定心力衰竭（P<0.01）、心房颤动（P<0.01）和糖尿病（P<0.05）为死亡预测指标。
LVHT患者QRS波群、PR间期和QTc间期延长与心力衰竭和左心室扩张相关，但与NMDs无关。QEMs在LVHT中的预后作用需要在更大规模的研究中进一步探讨。
