Mbakwem Amam C, Bauersachs Johann, Viljoen Charle, Hoevelmann Julian, van der Meer Peter, Petrie Mark C, Mebazaa Alexandre, Goland Sorel, Karaye Kamilu, Laroche Cécile, Sliwa Karen
Department of Medicine, College of Medicine, University of Lagos, Idi Araba, Lagos, Nigeria.
Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
ESC Heart Fail. 2021 Apr;8(2):879-889. doi: 10.1002/ehf2.13172. Epub 2021 Jan 16.
In peripartum cardiomyopathy (PPCM), electrocardiography (ECG) and its relationship to echocardiography have not yet been investigated in large multi-centre and multi-ethnic studies. We aimed to identify ECG abnormalities associated with PPCM, including regional and ethnic differences, and their correlation with echocardiographic features.
We studied 411 patients from the EURObservational PPCM registry. Baseline demographic, clinical, and echocardiographic data were collected. ECGs were analysed for rate, rhythm, QRS width and morphology, and QTc interval. The median age was 31 [interquartile range (IQR) 26-35] years. The ECG was abnormal in > 95% of PPCM patients. Sinus tachycardia (heart rate > 100 b.p.m.) was common (51%), but atrial fibrillation was rare (2.27%). Median QRS width was 82 ms [IQR 80-97]. Left bundle branch block (LBBB) was reported in 9.30%. Left ventricular (LV) hypertrophy (LVH), as per ECG criteria, was more prevalent amongst Africans (59.62%) and Asians (23.17%) than Caucasians (7.63%, P < 0.001) but did not correlate with LVH on echocardiography. Median LV end-diastolic diameter (LVEDD) was 60 mm [IQR 55-65] and LV ejection fraction (LVEF) 32.5% [IQR 25-39], with no significant regional or ethnic differences. Sinus tachycardia was associated with an LVEF < 35% (OR 1.85 [95% CI 1.20-2.85], P = 0.006). ECG features that predicted an LVEDD > 55 mm included a QRS complex > 120 ms (OR 11.32 [95% CI 1.52-84.84], P = 0.018), LBBB (OR 4.35 [95% CI 1.30-14.53], P = 0.017), and LVH (OR 2.03 [95% CI 1.13-3.64], P = 0.017).
PPCM patients often have ECG abnormalities. Sinus tachycardia predicted poor systolic function, whereas wide QRS, LBBB, and LVH were associated with LV dilatation.
在围产期心肌病（PPCM）中，尚未在大型多中心和多民族研究中对心电图（ECG）及其与超声心动图的关系进行研究。我们旨在确定与PPCM相关的心电图异常，包括区域和种族差异，以及它们与超声心动图特征的相关性。
我们研究了来自欧洲PPCM观察登记处的411例患者。收集了基线人口统计学、临床和超声心动图数据。分析心电图的心率、心律、QRS波宽度和形态以及QTc间期。中位年龄为31岁[四分位间距（IQR）26 - 35岁]。超过95%的PPCM患者心电图异常。窦性心动过速（心率>100次/分钟）很常见（51%），但房颤很少见（2.27%）。中位QRS波宽度为82毫秒[IQR 80 - 97]。左束支传导阻滞（LBBB）的报告发生率为9.30%。根据心电图标准，左心室（LV）肥厚（LVH）在非洲人（59.62%）和亚洲人（23.17%）中比白种人（7.63%，P<0.001）更普遍，但与超声心动图上的LVH不相关。左心室舒张末期内径（LVEDD）中位值为60毫米[IQR 55 - 65]，左心室射血分数（LVEF）为32.5%[IQR 25 - 39]，无显著的区域或种族差异。窦性心动过速与LVEF<35%相关（比值比1.85[95%置信区间1.20 - 2.85]，P = 0.006）。预测LVEDD>55毫米的心电图特征包括QRS波群>120毫秒（比值比11.32[95%置信区间1.52 - 84.84]）、LBBB（比值比4.35[95%置信区间1.30 - 14.53]，P = 0.017）和LVH（比值比2.03[95%置信区间1.13 - 3.64]，P = 0.017）。
PPCM患者常有心电图异常。窦性心动过速预示收缩功能不良，而宽QRS波、LBBB和LVH与左心室扩张有关。
