Pignone A, Matucci-Cerinic M, Becucci A, de Leonardis V, Lombardi A, Fabiani D, Bernardo P, Scaletti C, Carossino A M, Cagnoni M
Istituto di Clinica Medica IV, Università degli Studi di Firenze.
Ann Ital Med Int. 1994 Jul-Sep;9(3):141-5.
The aim of our study was to ascertain the prevalence of ventricular late potentials (VLP) in systemic sclerosis (SSc) and their correlation with the immunologic patterns and cutaneous and pulmonary involvement of the disease. Ventricular late potentials, which are low-amplitude high-frequency signals present in the terminal portion of the QRS complex, express the delayed and fragmented depolarization of ventricular myocardial fibers. Observed in myocardial interstitial fibrosis, they are characteristic of the myocardial alterations occurring in SSc. Twenty-six patients with SSc (1 man, 25 women) with a confirmed lack of cardiac involvement (negative history and normal clinical, electrocardiographic, and echocardiographic findings) underwent signal averaged high resolution electrocardiography. Pulmonary involvement was evaluated by pulmonary function tests and high resolution computed tomography. The degree of cutaneous involvement was assessed by skin score. In the patients with SSc, VLP presence with time-domain analysis was 30.8% when a 25-250 Hz pass-band filter was used and 26.9% when a 40-250 Hz pass-band filter was used whereas with frequency domain analysis it was 23.1%. Ventricular late potentials were confirmed in 7.7% of the control subjects, no matter what filter or technique was used. No significant correlations among VLP, pulmonary involvement, skin score and specific antibody patterns were found. Although this technique requires further consolidation, it seems to have the potential for use as an early index of myocardial fibrosis.
我们研究的目的是确定系统性硬化症（SSc）中心室晚电位（VLP）的患病率及其与疾病的免疫模式、皮肤和肺部受累情况的相关性。心室晚电位是QRS波群终末部分出现的低振幅高频信号，它表示心室肌纤维的延迟和碎裂去极化。在心肌间质纤维化中观察到，它们是SSc中发生的心肌改变的特征。26例确诊无心脏受累（病史阴性，临床、心电图和超声心动图检查结果正常）的SSc患者（1例男性，25例女性）接受了信号平均高分辨率心电图检查。通过肺功能测试和高分辨率计算机断层扫描评估肺部受累情况。通过皮肤评分评估皮肤受累程度。在SSc患者中，使用25 - 250Hz带通滤波器时，时域分析显示VLP阳性率为30.8%，使用40 - 250Hz带通滤波器时为26.9%，而频域分析时为23.1%。无论使用何种滤波器或技术，7.7%的对照受试者中证实存在心室晚电位。未发现VLP、肺部受累、皮肤评分和特异性抗体模式之间存在显著相关性。尽管这项技术需要进一步完善，但它似乎有潜力作为心肌纤维化的早期指标。
