Prognostic value of electrocardiograms, ventricular late potentials, ventricular arrhythmias, and left ventricular systolic dysfunction in patients with Duchenne muscular dystrophy
Prognostic value of electrocardiograms, ventricular late potentials, ventricular arrhythmias, and left ventricular systolic dysfunction in patients with Duchenne muscular dystrophy
复制标题
DOI：
10.1016/s0002-9149(02)02195-1
复制
发表时间：
2002-04-01
影响因子：
2.8
通讯作者：
Santarone, M
中科院分区：
文献类型：
--
作者：
Corrado, G;Lissoni, A;Santarone, M
心肌受累是Duchenne型肌营养不良症(DMD)患者的常见表现。然而，标准心电图、室性心律失常、室晚电位和左心室收缩功能不全的预后价值还没有得到广泛的研究。84例DMD患者(年龄18.6±4.8岁)接受了标准和信号平均心电图、24小时HALTER监测和超声心动图检查。心电图异常、频发室性早搏、LPs和左心室收缩功能不全的发生率分别为71%、32%、28%和35%。中位随访期为76个月(5~106个月)。随访期死亡率为27%。典型的DMD心电图改变、室性心律失常模式和LP不是死亡率的预测因素。相反，超声心动图检测到的左心室收缩功能不全是随访期死亡的一个强有力的先兆(p=0.013，危险比3.14，95%可信区间1.27-7.79)。因此，超声心动图对左心室收缩功能不全的评估可提供DMD患者的预后信息。在这些患者中，心电图改变、室性心律失常和LP对预测死亡率没有预后价值。(C)2002年，由Excerpta Medica，Inc.
Myocardial involvement is a common finding in patients with Duchenne-type muscular dystrophy (DMD). Nevertheless, the prognostic values of standard electrocardiogram (ECG), ventricular arrhythmias, ventricular late potentials (LPs), and left ventricular (LV) systolic dysfunction have not been extensively investigated. Eighty-four patients with DMD (aged 18.6 +/- 4.8 years) underwent standard and signal-averaged electrocardiography, 24-hour Halter monitoring, and echocardiography. The prevalence of electrocardiographic abnormalities, frequent ventricular premature complexes, LPs, and LV systolic dysfunction was 71%,32%, 28%, and 35%, respectively. Median follow-up was 76 months (range 5 to 106). The mortality rate in the follow-up period was 27%. The typical DMD electrocardiographic alterations, ventricular arrhythmic pattern, and LPs were not predictors of mortality. In contrast, the presence of LV systolic dysfunction detected on echocardiography was a powerful pre lictior of mortality in the follow up period (p = 0.013, hazard ratio 3.14, 95% confidence interval 1.27 to 7.79). Thus, echocardiographic assessment of LV systolic dysfunction provides prognostic information in patients with DMD. Electrocardiographic alterations, ventricular arrhythmias, and LPs have no prognostic value in predicting mortality in these patients. (C) 2002 by Excerpta Medica, Inc.