Autonomic nervous system imbalance and left ventricular systolic dysfunction as potential candidates for arrhythmogenesis in Becker muscular dystrophy
Autonomic nervous system imbalance and left ventricular systolic dysfunction as potential candidates for arrhythmogenesis in Becker muscular dystrophy
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DOI：
10.1016/s0167-5273(97)02933-1
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发表时间：
1997-05-23
影响因子：
3.5
通讯作者：
Iacono, A
中科院分区：
文献类型：
--
作者：
Ducceschi, V;Nigro, G;Iacono, A
我们评估了20例贝克肌营养不良症（BMD）患者的心肌概况，寻找心肌事件严重程度、心脏自主平衡（通过时域心率变异性分析评估）和左心室收缩功能受损程度之间的可能相关性。14名男性健康个体作为对照组。BMD受试者的SDNN（P=0.013）、SDANN指数（P=0.008）和24小时平均心率（P=0.002）较低。BMD受试者的室性早搏总数（totPVB）和1000次心跳中的PVB数（PVB/1000）也较高（分别为P=0.05和P=0.046）。两组24 h平均QTc和24 h最长QT间期无差异。总PVB和PVB/1000与射血分数（r=-0.620，P=0.004和r=-0.517，P=0.019）和缩短分数（r=-0.568，P=0.009和r=-0.469，P=0.037）呈负相关。24 h平均QTc与射血分数（r=-0.520，P =0.019）和短轴缩短分数（r=-0.491，P =0.028）呈负相关。这些数据表明，在BMD有心脏自主神经功能不平衡的交感神经优势和室性心律失常的易感性增加，即使在没有明显的心肌病。此外，BMD中代谢异常的严重程度似乎与左心室收缩功能障碍的程度密切相关。(C)1997 Elsevier Science爱尔兰有限公司
We evaluated the arrhythmic profile in a population of 20 Becker muscular dystrophy (BMD) patients searching for possible correlations between the severity of the arrhythmic events, the cardiac autonomic balance (assessed by heart rate variability analysis in the time domain) and the degree of left ventricular systolic impairment. A population of 14 male healthy individuals served as the control group. BMD subjects exhibited lower values of SDNN (P=0.013), SDANN index (P=0.008) and 24-h mean heart rate (P=0.002). The total number of premature ventricular beats (totPVB) and the number of PVB out of 1000 heartbeats (PVB/1000) appeared also higher in BMD subjects (P=0.05 and P=0.046, respectively). No difference was found in terms of 24-h mean QTc and 24-h longest QT among the two groups. TotPVB and PVB/1000 were inversely related to both the ejection fraction (r=-0.620, P=0.004 and r=-0.517, P=0.019) and to the shortening fraction (r=-0.568, P=0.009 and r=-0.469, P=0.037). Twenty-four-h mean QTc was also inversely related to both the ejection fraction (r=-0.520, P=0.019) and the fractional shortening (r=-0.491, P=0.028). These data suggest that in BMD there is cardiac autonomic imbalance characterized by sympathetic predominance and an increased susceptibility to ventricular arrhythmias, even in the absence of overt cardiomyopathy. Furthermore, the severity of the arrhythmic profile in BMD appears closely related to the degree of left ventricular systolic dysfunction. (C) 1997 Elsevier Science Ireland Ltd.