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印度尼西亚东部地区利用远程医疗检测布加综合征:一项多中心前瞻性观察研究。

Telemedicine for detecting Brugada Syndrome in eastern Indonesia: A multi-center prospective observational study.

作者信息

Amir Muzakkir, Munizu Muhaimin, Mappangara Idar, Adam Andi Tiara Salengke

机构信息

Department of Cardiology and Vascular Medicine, Faculty of Medicine, Hasanuddin University/Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia.

Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.

出版信息

Ann Med Surg (Lond). 2021 Apr 21;65:102334. doi: 10.1016/j.amsu.2021.102334. eCollection 2021 May.

Abstract

BACKGROUND

The incidence of Brugada syndrome has been reported to occur mostly in Asian countries. However, key countries such as Indonesia, the largest-populated Southeast Asian country, have yet to report any existing data regarding the incidence of Brugada syndrome among its population. Detecting these patients has been challenging, especially in primary healthcare settings, which generally have limited resources. Telemedicine may represent an ideal solution for initial diagnosis to determine if a patient may have this condition.

METHODS

We collected and analyzed numerous 12-lead electrocardiograms (ECG) of patients who visited various healthcare centers in Makassar for routine medical check-up between June 2017-April 2018. Electrocardiograms from these centers were sent to the Cardiac Center at Dr. Wahidin Sudirohusodo Hospital in Makassar via telemedicine.

RESULTS

During the period, we successfully obtained 9558 ECGs. While none of the patients were initially suspected of Brugada Syndrome, we found 102 (1.07%) among them to have a Brugada ECG pattern (BrEP). BrEP was more commonly found in males compared to females (67.6% vs. 32.4% of the cases found). There were significant differences in the number of confirmed cases among the types of BrEP for male and female patients. The number of confirmed cases of BrEP in male and female patients were significantly different (p < 0.05), where the number of cases for male vs. female was 8 vs. 4 for type 1, 17 vs. 1 for type 2, and 44 vs. 28 for type 3.

CONCLUSION

Brugada syndrome is a disease that is at grave risk of being frequently underdiagnosed. Our study indicates that telemedicine can become an appropriate tool that can assist physicians in detecting suspected patients. Future efforts should also be directed at studying the possible use of telemedicine for detecting other similarly rare conditions.

摘要

背景

据报道, Brugada综合征的发病率在亚洲国家最为常见。然而,印度尼西亚作为东南亚人口最多的主要国家,尚未报告其人群中Brugada综合征发病率的现有数据。检测这些患者具有挑战性,尤其是在资源普遍有限的基层医疗环境中。远程医疗可能是初步诊断以确定患者是否患有该疾病的理想解决方案。

方法

我们收集并分析了2017年6月至2018年4月期间在望加锡各医疗中心进行常规体检的患者的大量12导联心电图(ECG)。这些中心的心电图通过远程医疗发送到望加锡瓦希丁·苏迪罗胡索多医院的心脏中心。

结果

在此期间,我们成功获得了9558份心电图。虽然最初没有患者被怀疑患有Brugada综合征,但我们发现其中102例(1.07%)有Brugada心电图模式(BrEP)。与女性相比,BrEP在男性中更常见(分别占发现病例的67.6%和32.4%)。男性和女性患者中确诊病例的数量在不同类型的BrEP之间存在显著差异。男性和女性患者中BrEP确诊病例的数量有显著差异(p<0.05),其中1型男性与女性的病例数分别为8例和4例,2型为17例和1例,3型为44例和28例。

结论

Brugada综合征是一种经常漏诊风险很高的疾病。我们的研究表明,远程医疗可以成为协助医生检测疑似患者的合适工具。未来的努力还应致力于研究远程医疗在检测其他类似罕见疾病方面的可能用途。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/605c/8094895/a30042cb40ab/gr1.jpg

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