Montenegro Valdovinos P C, de Micheli A, Reyes López P A
Instituto Nacional de Cardiología Ignacio Chávez, INCICH, México, D.F.
Arch Inst Cardiol Mex. 1998 Jan-Feb;68(1):51-7.
Dilated Cardiomyopathy (DCM) is associated with many diseases. By means of epidemiologic, clinical and invasive diagnostic techniques, the etiology of DCM is identified almost in 50% of the cases. Chronic infection with Trypanosoma cruzi is recognized as a cause of DCM in Latin America. A blind study of 40 cases of DCM explores the electrovectorcardiographic data obtained in chronic chagasic cardiomyopathy (CCC). Twenty one of 40 patients fulfilled epidemiologic and seroimmunologic criteria for CCC, 19 had DCM. There were not differences between these groups in regard to sex or age. Patients suffering DCM had in addition diabetes mellitus, systemic hypertension or ischemic heart disease. Those with CCC had not comorbid diseases in 50% of the cases. Arrhythmias and conduction blocks were equally recognized in both groups, as well as ECG evidence of injury or necrosis (p > 0.05). However, ECG signs of subepicardial ischemia were a dominant feature in patients with CCC and normal epicardial coronary arteries (p < 0.05). Probably this finding is due to a small vessels damage, a pathogenic mechanism proposed in CCC.
扩张型心肌病（DCM）与多种疾病相关。通过流行病学、临床和侵入性诊断技术，几乎在50%的病例中可确定DCM的病因。克氏锥虫慢性感染被认为是拉丁美洲DCM的一个病因。一项对40例DCM病例的盲法研究探讨了慢性恰加斯心肌病（CCC）中获得的心电图数据。40例患者中有21例符合CCC的流行病学和血清免疫学标准，19例患有DCM。这些组在性别或年龄方面没有差异。患有DCM的患者还患有糖尿病、系统性高血压或缺血性心脏病。在50%的病例中，患有CCC的患者没有合并症。两组中均同样发现心律失常和传导阻滞，以及心电图显示的损伤或坏死证据（p>0.05）。然而，心外膜下缺血的心电图征象在CCC且心外膜冠状动脉正常的患者中是一个主要特征（p<0.05）。这一发现可能是由于小血管损伤，这是CCC中提出的一种致病机制。
