Suwa M, Hirota Y, Nakayama Y, Yoneda Y, Kusukawa J, Nakayama A, Kawamura K
Department of Internal Medicine, Osaka Medical College.
J Cardiol. 1989 Mar;19(1):147-53.
To clarify the prognostic significance of electrocardiographic changes in hypertrophic cardiomyopathy, we retrospectively evaluated serial electrocardiograms of 77 patients with hypertrophic cardiomyopathy who were followed more than one year. Conduction disturbance was analyzed as an electrocardiographic feature. Excluding four cases of sudden death, various conduction disturbances developed in 32 of the 73 patients. Intraventricular conduction delay was the most frequent among them (47%). Left ventricular end-diastolic pressure at the initial investigation was significantly higher, and clinical deterioration developed more frequently in patients with conduction disturbances, as compared with those without conduction disturbances. Histopathological analyses showed that proliferation of collagen fibers in the left ventricle was frequently associated with conduction disturbances. However, the electrocardiographic changes did not develop in the four patients who died suddenly. It was concluded that conduction disturbances comprise a significant parameter suggestive of poor prognoses in patients with hypertrophic cardiomyopathy, but that they are not predictors of sudden death.
为阐明肥厚型心肌病中心电图改变的预后意义，我们回顾性评估了77例随访时间超过1年的肥厚型心肌病患者的系列心电图。将传导障碍作为一项心电图特征进行分析。排除4例猝死病例后，73例患者中有32例出现了各种传导障碍。其中室内传导延迟最为常见（47%）。与无传导障碍的患者相比，初次检查时左心室舒张末期压力显著更高，且传导障碍患者临床病情恶化更为频繁。组织病理学分析显示，左心室胶原纤维增生常与传导障碍相关。然而，4例猝死患者未出现心电图改变。得出的结论是，传导障碍是肥厚型心肌病患者预后不良的一项重要指标，但并非猝死的预测因素。
