ELECTROCARDIOGRAPHY OF MYOCARDITIS REVISITED - CLINICAL AND PROGNOSTIC-SIGNIFICANCE OF ELECTROCARDIOGRAPHIC CHANGES
ELECTROCARDIOGRAPHY OF MYOCARDITIS REVISITED - CLINICAL AND PROGNOSTIC-SIGNIFICANCE OF ELECTROCARDIOGRAPHIC CHANGES
复制标题
DOI：
10.1016/0002-8703(92)90613-z
复制
发表时间：
1992-08-01
影响因子：
4.8
通讯作者：
CAMERINI, F
中科院分区：
文献类型：
--
作者：
MORGERA, T;DILENARDA, A;CAMERINI, F
为了阐明ECG的临床和预后价值，对45例组织学诊断为活动性心肌炎的连续患者（29例男性和男孩，16例女性和女孩;年龄36.8 ± 15岁;特发性心肌炎，39例）进行了ECG检查。在近期发作（≤1个月）的患者（21例）中，AV阻滞和复极异常是入院时的主要ECG特征，假性梗死模式（Q波+ST段抬高）通常预示着快速致死性病程（“暴发性心肌炎”）。左心房扩大和房颤，左心室肥大和LBBB，这在症状持续时间较长的患者中普遍存在，对应于初始血流动力学和超声心动图评价期间最严重的左心室功能障碍程度。自诊断后58 ± 24个月的总体死亡率为29%。异常QRS波群和LBBB是生存不良的标志，独立于左心室和右心室功能的初始指标，这两者都表明心源性猝死的倾向增加。
To clarify the clinical and prognostic value of the ECG, an ECG review was undertaken in 45 consecutive patients with a histologic diagnosis of active myocarditis (29 men and boys and 16 women and girls; age, 36.8 ± 15 years; idiopathic myocarditis, 39 cases). In patients (21) with symptoms of recent onset (≤1 month) AV block and repolarization abnormalities were the prevailing ECG features at the time of admission, and a pseudoinfarction pattern (Q waves plus ST-segment elevation) frequently heralded a rapidly fatal course (“fulminant myocarditis”). Left atrial enlargement and atrial fibrillation, left ventricular hypertrophy and LBBB, which prevailed in patients who had symptoms for longer periods, corresponded to the most severe degree of left ventricular dysfunction during the initial hemodynamic and echocardiographic evaluation. The overall mortality rate after 58 ± 24 months from the time of diagnosis was 29%. Abnormal QRS complexes and LBBB were markers of poor survival, independently of initial indexes of left and right ventricular function, both of which indicate an increased propensity for sudden cardiac death.