Diagnostic value of P-waves in children with idiopathic restrictive cardiomyopathy
Diagnostic value of P-waves in children with idiopathic restrictive cardiomyopathy
复制标题
P波对小儿特发性限制性心肌病的诊断价值
DOI：
10.1007/s00380-021-01784-4
复制
发表时间：
2021
影响因子：
1.5
通讯作者：
Nakano S
中科院分区：
文献类型：
--
作者：
Muraji S;Sumitomo N;Imamura T;Yasuda K;Nishihara E;Iwamoto M;Tateno S;Doi S;Hata T;Kogaki S;Horigome H;Ohno S;Ichida F;Nagashima M;Yoshinaga M;Nakano S
限制性心肌病（RCM）是一种少见的心肌病，以舒张功能受损为主，预后较差。据报道，几乎所有RCM患者由于心房负荷过重而出现异常的p波。本研究旨在揭示RCM患者的p波特征，提出儿童12导联心电图（ECG）诊断RCM的指标。我们回顾性调查了1979年至2013年在日本15个研究所首次就诊的特发性RCM患儿的17例心电图。RCM组根据年龄（小学[ES]和初中[JHS]学生）和诊断开始（校心筛查心电图异常[e-RCM]和一些心血管症状[s-RCM]）分为4组，ES/e-RCM组（n= 5）、ES/s-RCM组（n= 4）、JHS/e-RCM组（n= 4）和JHS/s-RCM组（n= 4）。采用鹿儿岛县2016年小学一年级ES学生（16770名）和小学一年级JHS学生（18126名）校心筛查心电图作为年龄匹配对照组。对于两组之间的比较，我们通过计算两组的平均值和标准差来使用效应大小“Hedge’sg”。效应量为0.8（或更高）时，重叠量为53%（或更少）。导联V1 （P1 + P2 V1）正反向振幅绝对值之和的效应量最大，ES/e-RCM、ES/s-RCM、JHS/e-RCM和JHS/s-RCM的效应量分别为15.8、22.1、9.4和10.3。P1 + P2 V1 > 200 μV能够在所有RCM患者中起统治作用，因此，我们提出200 μV作为筛选的截止值。综上所述，学校心脏筛查中的P1 + P2 V1可能有助于发现学龄儿童无症状或早期RCM。
Restrictive cardiomyopathy (RCM) is a rare myocardial disease with an impaired diastolic function and poor prognosis. Almost all RCM patients are reported to have abnormal P-waves due to atrial overloading. This study aimed to reveal the characteristics of the P-waves in RCM patients and to suggest the diagnostic index of RCM in children with a 12-lead electrocardiogram (ECG). We retrospectively investigated 17 ECGs of children with idiopathic RCM during the initial visit at 15 institutes in Japan between 1979 and 2013. The RCM group was divided into four groups based on the age (elementary school [ES] and junior high school [JHS] students) and inception of the diagnosis (abnormal ECG on school-heart-screening [e-RCM] and some cardiovascular symptoms [s-RCM]), the ES/e-RCM (n= 5), ES/s-RCM (n= 4), JHS/e-RCM (n= 4), and JHS/s-RCM (n= 4) groups. As an aged-match control group, school-heart-screening ECGs of 1st-grade ES students (16,770 students) and 1st-grade JHS students (18,126 students) from Kagoshima in 2016 were adopted. For a comparison between the groups, we used the effect size “Hedge’sg” by calculating the mean and standard deviation of the two groups. An effect size of 0.8 (or above) had an overlap of 53% (or less). The effect sizes of the sum of the absolute values of the forward and backward amplitudes in lead V1 (P1 + P2 V1) was the largest, and the ES/e-RCM, ES/s-RCM, JHS/e-RCM, and JHS/s-RCM were 15.8, 22.1, 9.4, and 10.3, respectively. A P1 + P2 V1 > 200 μV was able to rule in all RCM patients, thus, we proposed 200 µV as the cutoff value for screening purposes. In conclusion, the P1 + P2 V1 in the school-heart-screening may be useful for detecting asymptomatic or early-stage RCM in school-age children.
登录
查看更多内容
[心脏和血管]。
DOI：
10.1007/380.1615-2573
发表时间：
1966
期刊：
Klinicheskaia meditsina
影响因子：
--
作者：
V. A. Val'dman
通讯作者：
V. A. Val'dman
影响因子：
2.8
作者：
Anderson, Heather N.;Cetta, Frank;Johnson, Jonathan N.
通讯作者：
Johnson, Jonathan N.
影响因子：
3.3
作者：
Hayashi, Tamaki;Tsuda, Etsuko;Echigo, Shigeyuki
通讯作者：
Echigo, Shigeyuki
影响因子：
39.3
作者：
Charron, Philippe;Elliott, Perry M.;Maggioni, Aldo P.
通讯作者：
Maggioni, Aldo P.
影响因子：
3.8
作者：
Paller MS;Martin CM;Pierpont ME
通讯作者：
Pierpont ME