Roberts N K, Cabeen W R, Moss J, Clements P J, Furst D E
Ann Intern Med. 1981 Jan;94(1):38-40. doi: 10.7326/0003-4819-94-1-38.
A prospective noninvasive electrocardiographic study was done on 50 patients with progressive systemic sclerosis. Thirty-two percent had abnormalities on the resting electrocardiogram, of which the commonest were left anterior fascicular block (16%) and first-degree heart block (8%). The 24-hour ambulatory continuous tape-recorded electrocardiograms showed serious abnormalities in 62% of the patients: supraventricular tachycardias (32%), conduction disturbances (14%), coupled ventricular extrasystoles (20%), and ventricular tachycardia (10%). Intracardiac electrophysiologic data were obtained in 20 of these patients, and functional abnormalities of the sinus node, atria, and atrioventricular node were noted in seven, nine, and 10 patients, respectively. One patient had prolonged His-Purkinje conduction time. Of the 20 patients who had electrophysiologic studies, only six had entirely normal findings. These results suggest a much higher degree of cardiac involvement in progressive systemic sclerosis than previously believed. We postulate that the first-degree heart block and supraventricular tachycardias may derive from a similar pathologic process, namely, fibrous atrophy of the proximal atrioventricular node.
对50例进行性系统性硬化症患者进行了一项前瞻性无创心电图研究。32%的患者静息心电图有异常，其中最常见的是左前分支阻滞（16%）和一度房室传导阻滞（8%）。24小时动态连续磁带记录心电图显示62%的患者有严重异常：室上性心动过速（32%）、传导障碍（14%）、室性早搏（20%）和室性心动过速（10%）。其中20例患者获得了心内电生理数据，分别有7例、9例和10例患者窦房结、心房和房室结功能异常。1例患者希氏束-浦肯野纤维传导时间延长。在进行电生理研究的20例患者中，只有6例结果完全正常。这些结果表明，进行性系统性硬化症患者心脏受累程度比之前认为的要高得多。我们推测一度房室传导阻滞和室上性心动过速可能源于相似的病理过程，即近端房室结纤维性萎缩。
