Javanshiri Keivan, Siotis Alexander, Heyman Isak, Haglund Mattias
Division of Pathology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
Department of Clinical Sciences Helsingborg, Lund University, Helsingborg, Sweden.
Geroscience. 2025 Jan 10. doi: 10.1007/s11357-024-01479-4.
Increasing evidence suggests that Lewy body disease (LBD) is associated with clinically important cardiac complications, including sick sinus syndrome, atrial fibrillation and sudden cardiac death. The high prevalence of sick sinus syndrome and atrial fibrillation in LBD suggests the presence of disease-related atrial conduction disorders. To explore whether LBD is associated with atrial conduction disorders, electrocardiographic (ECG) P wave parameters were analyzed in a cohort of LBD patients (n = 74), using age-matched Alzheimer's disease (AD) patients (n = 25) as controls. P wave terminal force in V1 and P wave duration were found to be significantly greater in the LBD group than in the AD group. In addition, 43 (58%) individuals in the LBD exhibited pathological P wave terminal force (> 4000 µV*ms) vs 3 (12%) in the AD group, and 60 (81%) in the LBD group exhibited pathological P wave duration (≥ 120 ms), vs 13 (52%) in the AD group. The difference could not be explained by atrial fibrillation or atrial enlargement on echocardiogram. The clinical significance of pathological P wave parameters in LBD is unknown, but their presence suggests an atrial cardiomyopathy that could be due to cardiac alpha-synuclein deposition, autonomic dysfunction, or a combination thereof. Future research is warranted to elucidate whether this proposed disease-related atrial cardiomyopathy is related to cardiac alpha-synuclein deposition, whether it is causally related to cardiac complications in LBD, and whether pathological P wave parameters hold potential as a screening tool for cardiac complications in LBD.
越来越多的证据表明，路易体病（LBD）与具有临床重要意义的心脏并发症相关，包括病态窦房结综合征、心房颤动和心源性猝死。LBD中病态窦房结综合征和心房颤动的高患病率提示存在与疾病相关的心房传导障碍。为了探究LBD是否与心房传导障碍相关，对一组LBD患者（n = 74）的心电图（ECG）P波参数进行了分析，并以年龄匹配的阿尔茨海默病（AD）患者（n = 25）作为对照。发现LBD组的V1导联P波终末电势和P波时限显著大于AD组。此外，LBD组中有43例（58%）个体表现出病理性P波终末电势（> 4000 μV*ms），而AD组为3例（12%）；LBD组中有60例（81%）个体表现出病理性P波时限（≥ 120 ms），而AD组为13例（52%）。这种差异无法通过超声心动图检查发现的心房颤动或心房扩大来解释。LBD中病理性P波参数的临床意义尚不清楚，但它们的存在提示可能存在心房心肌病，其原因可能是心脏α-突触核蛋白沉积、自主神经功能障碍或两者兼而有之。有必要进行进一步研究，以阐明这种推测的与疾病相关的心房心肌病是否与心脏α-突触核蛋白沉积有关，是否与LBD中的心脏并发症存在因果关系，以及病理性P波参数是否有潜力作为LBD心脏并发症的筛查工具。
