Baskan Serra, Karaca Ozer Pelin, Orta Huseyin, Ozbingol Doruk, Yavuz Mustafa Lutfi, Ayduk Govdeli Elif, Nisli Kemal, Oztarhan Kazim
Department of Pediatric Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34134, Turkey.
Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34134, Turkey.
Diagnostics (Basel). 2023 Jul 15;13(14):2381. doi: 10.3390/diagnostics13142381.
The most common cause of death in patients with Duchenne muscular dystrophy (DMD) is cardiomyopathy. Our aim was to investigate the relationship between the Tpeak-Tend (Tp-e) interval and the premature ventricular contraction (PVC) burden and therefore early arrhythmic risk and cardiac involvement in DMD patients. Twenty-five patients with DMD followed by pediatric cardiology were included in the study. Those with a frequency of <1% PVC in the 24 h Holter were assigned to Group 1 ( = 15), and those with >1% were assigned to Group 2 ( = 10). Comparisons were made with healthy controls ( = 27). Left ventricular ejection fraction (LVEF) was lowest in Group 2 and highest in the control group ( < 0.001). LV end-diastolic diameter was greater in Group 2 than in Group 1 and the control group ( = 0.005). Pro-BNP and troponin levels were higher in Group 1 and Group 2 than in the control group ( = 0.001 and < 0.001, respectively). Tp-e interval was longer in Group 2 compared to Group 1 and the control group ( < 0.001). The LVEF (OR 0.879, 95% CI 0.812-0.953; = 0.002) and Tp-e interval (OR 1.181, 95% CI 1.047-1.332; = 0.007) were independent predictors of PVC/24 h frequency of >1%. A Tp-e interval > 71.65 ms predicts PVC > 1%, with a sensitivity of 80% and a specificity of 90% (AUC = 0.842, 95% CI (0.663-1.000), = 0.001). Determination of Tp-e prolongation from ECG data may help in the determination of cardiac involvement and early diagnosis of arrhythmic risk in DMD.
杜氏肌营养不良症(DMD)患者最常见的死因是心肌病。我们的目的是研究T波峰-末间期(Tp-e)与室性早搏(PVC)负荷之间的关系,从而探讨DMD患者早期心律失常风险及心脏受累情况。本研究纳入了25例由儿科心脏病专家随访的DMD患者。24小时动态心电图中PVC频率<1%的患者被分配到第1组(n = 15),PVC频率>1%的患者被分配到第2组(n = 10)。并与健康对照组(n = 27)进行比较。第2组的左心室射血分数(LVEF)最低,对照组最高(P < 0.001)。第2组的左心室舒张末期内径大于第1组和对照组(P = 0.005)。第1组和第2组的脑钠肽前体(Pro-BNP)和肌钙蛋白水平高于对照组(分别为P = 0.001和P < 0.001)。与第1组和对照组相比,第2组的Tp-e间期更长(P < 0.001)。LVEF(OR 0.879,95%CI 0.812 - 0.953;P = 0.002)和Tp-e间期(OR 1.181,95%CI 1.047 - 1.332;P = 0.007)是PVC/24小时频率>1%的独立预测因素。Tp-e间期>71.65 ms可预测PVC>1%,敏感性为80%,特异性为90%(AUC = 0.842,95%CI(0.663 - 1.000),P = 0.001)。通过心电图数据测定Tp-e延长可能有助于确定DMD患者的心脏受累情况及心律失常风险的早期诊断。