Song Wenhua, Zheng Yi, Dong Mei, Zhong Lin, Bazoukis George, Perone Francesco, Li Guangping, Ng Chi Fai, Baranchuk Adrian, Tse Gary, Liu Tong
Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China.
Department of Cardiology, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai Shandong, China.
Curr Probl Cardiol. 2023 Feb;48(2):101478. doi: 10.1016/j.cpcardiol.2022.101478. Epub 2022 Nov 3.
Immune checkpoint inhibitors (ICIs) are associated with immune-related adverse events including myocarditis, whilst improving cancer-related outcomes. There is thus a clinical need to identify electrocardiographic manifestations of ICI-related myocarditis to guide clinical management. PubMed was searched for clinical studies and case reports describing electrocardiographic changes in patients with ICI-related myocarditis. A total of 6 clinical studies and 79 case reports were included. This revealed a range of presentations for patients on ICIs, including supraventricular arrhythmias, ventricular arrhythmias and heart block, and new changes of ST-T segment unrelated to coronary artery disease, ST-segment elevation or depression and T-wave abnormalities. Several patients showed low voltages in multiple leads and new onset Q-wave development. Patients with ICI-related myocarditis may develop new arrhythmia and ST-T changes, and infrequently low voltages in multiple leads.
免疫检查点抑制剂（ICIs）在改善癌症相关预后的同时，会引发包括心肌炎在内的免疫相关不良事件。因此，临床上需要识别ICI相关心肌炎的心电图表现，以指导临床管理。我们在PubMed上检索了描述ICI相关心肌炎患者心电图变化的临床研究和病例报告。共纳入6项临床研究和79例病例报告。这揭示了使用ICIs的患者有一系列表现，包括室上性心律失常、室性心律失常和心脏传导阻滞，以及与冠状动脉疾病无关的ST-T段新变化、ST段抬高或压低和T波异常。几名患者在多个导联出现低电压和新出现的Q波。ICI相关心肌炎患者可能会出现新的心律失常和ST-T变化，少数情况下会出现多个导联的低电压。
