Garzon S A, Lorga A M, Nicolau J C
Instituto de Moléstias Cardiovasculares, São José do Rio Preto-São Paulo, Brazil.
Sao Paulo Med J. 1995 Mar-Apr;113(2):802-13. doi: 10.1590/s1516-31801995000200011.
Conventional ECG still plays an important role in the overall knowledge of Chagas' cardiopathy, because of its importance in longitudinal and epidemiological studies, its diagnostic value, and its utility in prognostic evaluation. The authors discuss these aspects, as well as the use of eCG in the acute phase and the significance of a normal ECG in Chagas' disease. Correlations were made between ECG and Hemodynamic/angiographic variables among 1010 patients with positive laboratory tests for Chagas' disease: a) in the group with normal ECG there was no significant differences between symptomatic and non-symptomatic patients with regard to ejection fraction and angiographic abnormalities; b) slight abnormalities on the ECG corresponded to an intermediate level of severity of the disease, that is, between normal ECG and ECG with significant abnormalities C) fibrosis on the ECG was not predictive of akinesia in the related area on the angiography; d) combined ECG abnormalities generally correlated with greater myocardial compromises compared to isolated abnormalities; e) under multiple regression analysis the ECG abnormalities that independently correlated with depressed ejection fraction were: premature ventricular beats, ventricular tachycardia, left bundle branch block, atrial fibrillation, complete AV block, and anterior and inferior fibrosis. Male sex, cardiac insufficiency and cardiomegaly on the throat radiography were also significantly related.
传统心电图在恰加斯心肌病的整体认知中仍发挥着重要作用,这是因为它在纵向和流行病学研究中具有重要性、具备诊断价值以及在预后评估中具有实用性。作者讨论了这些方面,以及急性期心电图的应用和恰加斯病中心电图正常的意义。对1010例恰加斯病实验室检查呈阳性的患者的心电图与血流动力学/血管造影变量进行了相关性分析:a)在心电图正常的组中,有症状和无症状患者在射血分数和血管造影异常方面没有显著差异;b)心电图上的轻微异常对应于疾病的中等严重程度,即介于正常心电图和有显著异常的心电图之间;c)心电图上的纤维化并不能预测血管造影相关区域的运动不能;d)与孤立异常相比,复合心电图异常通常与更大程度的心肌损害相关;e)在多元回归分析中,与射血分数降低独立相关的心电图异常包括:室性早搏、室性心动过速、左束支传导阻滞、心房颤动、完全性房室传导阻滞以及前壁和下壁纤维化。男性、心脏功能不全和胸部X线片显示的心脏增大也具有显著相关性。