Ueda Yu, Slabaugh Taylor L, Walker Ashley L, Ontiveros Eric S, Sosa Paul-Michael, Reader Rachel, Roberts Jeffrey A, Stern Joshua A
Department of Medicine & Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States.
California National Primate Research Center, University of California, Davis, Davis, CA, United States.
Front Vet Sci. 2019 Jan 22;6:1. doi: 10.3389/fvets.2019.00001. eCollection 2019.
Hypertrophic cardiomyopathy (HCM) is frequently associated with sudden cardiac death, presumably due to the development of malignant arrhythmias. The risk of sudden cardiac death due to HCM has been reported to be predicted by assessing electrocardiographic (ECG) changes including frequencies and complexities of arrhythmias as well as heart rate variability (HRV) as an assessment of autonomic balance. Sudden cardiac death in association with naturally-occurring left ventricular hypertrophy (LVH) has been reported in a colony of rhesus macaques and is under investigation as a potential non-human primate model of human HCM. In the present study, 10 rhesus macaques with LVH and 10 without the signs of LVH confirmed by an echocardiographic examination were recruited for assessing ECG and HRV parameters. ECG morphology on 10-s, 6-lead ECG analysis, and the frequency and complexity of arrhythmias as well as HRV on 20-h ambulatory ECG Holter analyses were assessed. On the standard 10-s 6-lead ECG analysis, P wave and QRS complex duration as well as the QRS complex amplitude were significantly increased in the LVH-affected rhesus macaques compared to control rhesus macaques. Analysis of 20-h Holter monitoring revealed no statistically significant differences in the frequency or the complexity of arrhythmias between the LVH and the control groups. Several HRV parameters were smaller in the LVH group than the control group throughout the majority of Holter recordings showing periods of reduced variability, however, no statistically significant differences were achieved across groups and/or time points. These findings indicate that ECG analysis and Holter monitoring of rhesus macaques are feasible and that ECG morphological changes in association with LVH could be used as a possible component of an antemortem screening tool. The rhesus macaques of this study did not reveal clear indications of risk for sudden cardiac death. Further studies are necessary to determine the etiology of sudden cardiac death due in LVH affected rhesus macaques and identify if any parameters of arrhythmia assessment or HRV can be used to predict the development of sudden cardiac death.
肥厚型心肌病（HCM）常与心源性猝死相关，推测是由于恶性心律失常的发生。据报道，通过评估心电图（ECG）变化（包括心律失常的频率和复杂性）以及作为自主神经平衡评估指标的心率变异性（HRV），可以预测HCM导致的心源性猝死风险。在一群恒河猴中，已报道了与自然发生的左心室肥厚（LVH）相关的心源性猝死，目前正在作为人类HCM潜在的非人类灵长类动物模型进行研究。在本研究中，招募了10只经超声心动图检查确诊为LVH的恒河猴和10只无LVH体征的恒河猴，以评估ECG和HRV参数。评估了10秒6导联ECG分析的ECG形态、20小时动态心电图Holter分析中的心律失常频率和复杂性以及HRV。在标准的10秒6导联ECG分析中，与对照恒河猴相比，受LVH影响的恒河猴的P波和QRS波群时限以及QRS波群振幅显著增加。20小时Holter监测分析显示，LVH组和对照组之间心律失常的频率或复杂性没有统计学上的显著差异。在大多数显示变异性降低的Holter记录中，LVH组的几个HRV参数均小于对照组，然而，各组和/或各时间点之间未达到统计学上的显著差异。这些发现表明，对恒河猴进行ECG分析和Holter监测是可行的，与LVH相关的ECG形态变化可作为生前筛查工具的一个可能组成部分。本研究中的恒河猴未显示心源性猝死风险的明确迹象。有必要进一步研究以确定受LVH影响的恒河猴心源性猝死的病因，并确定心律失常评估或HRV的任何参数是否可用于预测心源性猝死的发生。
