Secchi M B, Wu S C, Obbiassi M, Oltrona L, Folli G
Arch Mal Coeur Vaiss. 1982 Nov;75(11):1297-309.
Electrocardiographic changes are well known in Duchenne's muscular dystrophy (DMD). Their cause is still controversial. The aim of this study was: to verify the genetic theory of these changes to improve our understanding of their pathogenesis, by studying the distribution and characteristics of the mother carriers; to determine whether electro-vectocardiography could be of value in detecting carriers of the disease. Fourteen patients aged from 7 to 17 years old with DMD underwent ECG and VCG. ECG changes were recorded in 13 of the 14 cases: increased amplitude of the R wave in the right precordial leads or deep Q waves (amplitude greater than or equal to 2 mm, duration less than 0,04 msec) in the peripheral or left precordial leads. The algebraic sum of R--S in V1 was greater than normal in 6 carriers. VCG criteria of posterior myocardial infarction were fulfilled in 11 patients. "Bites" were recorded in 4 patients and 8 carriers. Electrical changes were therefore found in both patients and carriers with equal significance: in the first group the main appearances were of pseudo-infarction, principally involving the posterior wall; in the second group, less specific changes, best recorded on VCG, suggesting foci of myocardial fibrosis were observed. We think that the "bites" recorded in 66 p. 100 of mothers, could be a useful parameter for detecting carrier subjects.
心电图改变在杜兴氏肌营养不良症(DMD)中是众所周知的。其病因仍存在争议。本研究的目的是:通过研究母亲携带者的分布和特征来验证这些改变的遗传理论,以增进我们对其发病机制的理解;确定心电向量图在检测该疾病携带者方面是否有价值。14例年龄在7至17岁的DMD患者接受了心电图(ECG)和心电向量图(VCG)检查。14例中有13例记录到心电图改变:右胸前导联R波振幅增加或外周或左胸前导联出现深Q波(振幅大于或等于2毫米,持续时间小于0.04毫秒)。6例携带者V1导联R - S代数和大于正常。11例患者符合后壁心肌梗死的心电向量图标准。4例患者和8例携带者记录到“咬迹”。因此,在患者和携带者中均发现了具有同等意义的电改变:在第一组中主要表现为假性梗死,主要累及后壁;在第二组中,观察到不太特异的改变,在心电向量图上记录最佳,提示心肌纤维化灶。我们认为,在66%的母亲中记录到的“咬迹”可能是检测携带者的一个有用参数。