[儿童肥厚型非梗阻性心肌病的心电图特征与肥厚分布的关系]

[Relation of electrocardiographic features and distribution of hypertrophy in hypertrophic non-obstructive cardiomyopathy during childhood].

作者信息

Kamiya Y, Oonaka M, Itoi T, Hamaoka K, Onouchi Z

机构信息

Department of Pediatrics, Fukui Cardiovascular Center.

出版信息

J Cardiol. 1994 Mar-Apr;24(2):91-106.

PMID:8164151

Abstract

The relationship between the electrocardiographic features and the distribution of ventricular hypertrophy in pediatric patients with hypertrophic non-obstructive cardiomyopathy (HNCM) aged from 6 to 16 years (mean 11.6 years) was studied during a period of 6 months to 10 years (mean 3.9 years). Hypertrophy in the three segments (anterior septum, lateral free wall, posterior free wall) of the left ventricle in 17 patients with HNCM was evaluated by two-dimensional echocardiography (short-axis cross section of the left ventricle) at the end-diastolic period. The 17 patients were divided into four groups according to the echocardiographic findings as follows: Group A: hypertrophy in the ventricular anterior septum with or without posterior septum (eight patients). Group B: hypertrophy in both the ventricular septum and lateral left ventricular free wall (three patients). Group C: hypertrophy in the lateral left ventricular free wall (three patients). Group D: hypertrophy in the posterior left ventricular free wall with or without posterior septum (three patients). The incidence of electrocardiographic abnormalities in each group was analyzed using serial standard 12-lead electrocardiography. Electrocardiographic abnormalities and the distribution of the ventricular hypertrophy were related as follows: Lateral free wall: increased SV1 + RV6 (p < 0.05), ST-T change in leads V5.6 (p < 0.01). Posterior free wall: ST-T change in leads II.aVF (p < 0.05). Electrocardiographic abnormalities in HNCM patients in the hypertrophy were: Group A: abnormal Q waves in leads II.III.aVF (75%) and V5.6 (50%), high voltage R waves in leads II.III.aVF (25%) and V1 (38%), low voltage R waves in leads V2.3 (13%) and V5.6 (38%), and ST-T changes in leads I.aVL (25%), II.aVF (13%) and V2-4 (50%). Group B: abnormal Q waves in leads II.III.aVF (33%), high voltage R wave in lead V1 (33%), increased SV1 + RV6 (67%), low voltage R waves in leads V2.3 (33%) and V5.6 (33%), and ST-T changes in leads I.aVL (33%), II.aVF (33%), V2-4 (67%) and V5.6 (67%). Group C: abnormal Q waves in leads I.aVL (33%) and V5.6 (33%), high voltage R waves in leads II.III.aVF (33%), V1 (67%) and V5.6 (33%), increased SV1 + RV6 (67%), low voltage R waves in leads V5.6 (33%) and ST-T changes in leads II.aVF (33%), V2-4 (33%) and V5.6 (67%).

摘要

对6至16岁（平均11.6岁）的肥厚型非梗阻性心肌病（HNCM）儿科患者，在6个月至10年（平均3.9年）期间研究了心电图特征与心室肥厚分布之间的关系。通过二维超声心动图（左心室短轴切面）在舒张末期评估17例HNCM患者左心室三个节段（前间隔、外侧游离壁、后游离壁）的肥厚情况。根据超声心动图结果将17例患者分为四组：A组：心室前间隔肥厚伴或不伴后间隔（8例患者）。B组：心室间隔和左心室外侧游离壁均肥厚（3例患者）。C组：左心室外侧游离壁肥厚（3例患者）。D组：左心室后游离壁肥厚伴或不伴后间隔（3例患者）。使用连续标准12导联心电图分析每组心电图异常的发生率。心电图异常与心室肥厚分布的关系如下：外侧游离壁：SV1 + RV6增加（p < 0.05），V5、V6导联ST-T改变（p < 0.01）。后游离壁：II、aVF导联ST-T改变（p < 0.05）。肥厚型HNCM患者的心电图异常情况如下：A组：II、III、aVF导联异常Q波（75%）和V5、V6导联（50%）；II、III、aVF导联高电压R波（25%）和V1导联（38%）；V2、V3导联低电压R波（13%）和V5、V6导联（38%）；I、aVL导联（25%）、II、aVF导联（13%）和V2 - 4导联（50%）ST-T改变。B组：II、III、aVF导联异常Q波（33%），V1导联高电压R波（33%），SV1 + RV6增加（67%），V2、V3导联低电压R波（33%）和V5、V6导联（33%）；I、aVL导联（33%）、II、aVF导联（33%）、V2 - 4导联（67%）和V5、V6导联（67%）ST-T改变。C组：I、aVL导联（33%）和V5、V6导联（33%）异常Q波；II、III、aVF导联（33%）、V1导联（67%）和V5、V6导联（33%）高电压R波；SV1 + RV6增加（67%）；V5、V6导联低电压R波（33%）；II、aVF导联（33%）、V2 - 4导联（33%）和V5、V6导联（67%）ST-T改变。