致心律失常性右室心肌病长期随访的运动试验
Exercise testing for long-term follow-up in arrhythmogenic right ventricular cardiomyopathy.
作者信息
Karlsson Daniel, Engvall Jan, Ando Agota Alfoldine, Aneq Meriam Åström
机构信息
Department of Clinical Physiology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
Department of Clinical Physiology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
出版信息
J Electrocardiol. 2017 Mar-Apr;50(2):176-183. doi: 10.1016/j.jelectrocard.2016.10.011. Epub 2016 Oct 28.
OBJECTIVES
We investigated arrhythmia, electrocardiography and physical work capacity (PWC) in the follow-up of ARVC.
DESIGN
Twenty-three patients (13 men; age 41±12years) fulfilling diagnostic criteria were re-investigated after at least five years.
RESULTS
Ventricular arrhythmia during exercise testing (ET) was present in 14 patients (61%) and showed variation between examinations. In eleven (48%), complex ventricular ectopic activity was observed at peak exercise or immediately thereafter. Mutations known to be pathogenic in ARVC were present in 13 patients (57%) of which 11 developed complex ventricular arrhythmia at ET. PWC at baseline was 190±66W (104±26%) decreasing to 151±61W (91±23%, p=0.008) after 10.7years.
CONCLUSION
The appearance of ventricular arrhythmia during exercise testing showed temporal variation but was frequent in patients with relevant genetic mutation. Physical exercise capacity decreased over time in patients with ARVC in excess to the age-related deterioration and regardless of medication.
目的
我们在致心律失常性右室心肌病（ARVC）随访中研究了心律失常、心电图及体力工作能力（PWC）。
设计
23例符合诊断标准的患者（13例男性；年龄41±12岁）在至少5年后接受再次检查。
结果
运动试验（ET）期间14例患者（61%）出现室性心律失常，且检查之间存在差异。11例（48%）在运动高峰或之后立即观察到复杂室性异位活动。已知在ARVC中致病的突变存在于13例患者（57%）中，其中11例在ET时发生复杂室性心律失常。基线时PWC为190±66W（104±26%），10.7年后降至151±61W（91±23%，p=0.008）。
结论
运动试验期间室性心律失常的出现显示出时间上的差异，但在有相关基因突变的患者中很常见。ARVC患者的体力运动能力随时间下降，超过与年龄相关的恶化程度，且与用药无关。
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