Wang Chunya, Gao Hai, Sun Jie, Wang Limin, Li Weijie, Zu Xiaolin, Cheng Peili, Wei Shizhang, Zhao Pan
Coronary Heart Disease Center, Beijing Anzhen Hospital, Capital Medical University.
Fifth Medical Center (formerly Beijing 302 Hospital), Chinese PLA General Hospital.
Eur J Gastroenterol Hepatol. 2022 Nov 1;34(11):1147-1150. doi: 10.1097/MEG.0000000000002432. Epub 2022 Aug 23.
Wilson's disease (WD) is an inherited disorder with perturbations in copper metabolism and can cause multiorgan damage. This study aims to explore cardiac findings mainly based on electrocardiography (ECG) in WD patients.
We retrospectively enrolled adult patients who were diagnosed with WD between January 2011 and December 2020. Demographic and clinical data were collected and reevaluated.
A total of 126 patients were included. There were 71 men and 55 women. The mean age was 27.2 years. Ninety-nine had hepatic presentation as the initial symptom and 27 had neuropsychiatric presentation as the initial symptom. Thirty-seven patients (29.4%) had cardiac manifestations. Of these patients, nine presented apparent cardiac symptoms (three with discontinuous chest tightness, three with dizziness, two with palpitation and one with atypical chest pain) and 28 had asymptomatic electrocardiography (ECG) abnormalities. Among the nine patients, four had second- or third-degree atrioventricular block, three had ST-segment change and two had ventricular tachycardia. ECG abnormalities in the 28 patients included increase in the width of the QRS complex in 8, atrial premature beats in 8, T-wave inversion in 5, P-wave inversion in 2, sinus bradycardia in 2, ST-segment change in 2, and coexistence of sinus bradycardia and T-wave inversion in 1. No statistical difference (P = 0.32) existed in the occurrence of ECG abnormalities between patients with hepatic presentation (27/99) and those with neuropsychiatric presentation (10/27).
Cardiac involvement is not rare in adult WD patients. We suggest that cardiac evaluation should be routinely performed in the population.
威尔逊病（WD）是一种遗传性疾病，铜代谢紊乱，可导致多器官损害。本研究旨在主要基于心电图（ECG）探讨WD患者的心脏表现。
我们回顾性纳入了2011年1月至2020年12月期间被诊断为WD的成年患者。收集并重新评估人口统计学和临床数据。
共纳入126例患者。其中男性71例，女性55例。平均年龄为27.2岁。99例以肝脏表现为首发症状，27例以神经精神表现为首发症状。37例患者（29.4%）有心脏表现。在这些患者中，9例出现明显的心脏症状（3例间断性胸闷、3例头晕、2例心悸和1例非典型胸痛），28例有无症状心电图异常。在这9例患者中，4例有二度或三度房室传导阻滞，3例有ST段改变，2例有室性心动过速。28例患者的心电图异常包括8例QRS波群增宽、8例房性早搏、5例T波倒置、2例P波倒置、2例窦性心动过缓、2例ST段改变、1例窦性心动过缓和T波倒置并存。肝脏表现患者（27/99）和神经精神表现患者（10/27）的心电图异常发生率无统计学差异（P = 0.32）。
成年WD患者心脏受累并不罕见。我们建议在该人群中常规进行心脏评估。
