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[脊髓性肌萎缩症的心脏受累情况。8例前瞻性研究]

[Cardiac involvement in Kugelberg-Welander disease. A prospective study of 8 cases].

作者信息

Elkohen M, Vaksmann G, Elkohen M R, Francart C, Foucher C, Rey C

机构信息

Service de cardiologie infantile, Hôpital Roger Salengro, CHRU de Lille.

出版信息

Arch Mal Coeur Vaiss. 1996 May;89(5):611-7.

PMID:8758571
Abstract

Kugelberg-Welander disease is a juvenile form of slowly progressive spiral amyotrophy in which the incidence of cardiac involvement is difficult to appreciate as cases are sporadic. Classically, it presents with atrial hyperexcitability with variable degrees of atrioventricular block. In order to assess the prevalence of cardiac involvement in this condition, the authors undertook a prospective study in 8 patients with Kugelberg-Welander disease. All underwent clinical and paraclinical examinations to assess cardiac function and rhythm. Doppler echocardiography, myocardial scintigraphy with Thallium 201 and Technetium99m, resting ECG. 24 hour Holter monitoring and signal averaged ECG were performed in all cases. This unique study detected one patient with infraclinical disease of the conduction system who became symptomatic during the follow-up period and required definitive cardiac pacing. During the study, one 20 year old man with Kugelberg-Welander disease was admitted to hospital with dilated cardiomyopathy with a fatal outcome. Because of the small number of patients and after a review of the literature, this study is to be continued to obtain a more accurate evaluation of cardiac involvement in this neuromuscular disease.

摘要

库格伯格-韦兰德病是一种青少年型缓慢进展性螺旋肌萎缩症,由于病例为散发性,心脏受累的发生率难以确切知晓。典型表现为心房过度兴奋,并伴有不同程度的房室传导阻滞。为评估该病中心脏受累的患病率,作者对8例库格伯格-韦兰德病患者进行了一项前瞻性研究。所有患者均接受了临床和辅助检查,以评估心脏功能和节律。所有病例均进行了多普勒超声心动图、用铊201和锝99m进行的心肌闪烁显像、静息心电图、24小时动态心电图监测以及信号平均心电图检查。这项独特的研究发现1例传导系统亚临床疾病患者,该患者在随访期间出现症状,需要进行确定性心脏起搏治疗。在研究期间,1名患有库格伯格-韦兰德病的20岁男性因扩张型心肌病入院,最终死亡。由于患者数量较少,且在查阅文献后,本研究将继续进行,以更准确地评估这种神经肌肉疾病中心脏受累的情况。

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