[高性心肌病症中心电图异常的患病率:寻找的人会找到]
Zsolt Forrai1, Fanni Bánfi-Bacsárdi1,2, Dávid Pilecky1,2
11 Gottsegen Gyögy Országos Kardiovaszkuláris Intézet, Felnőtt Kardiológiai Osztály Budapest, Haller u. 29., 1096 Magyarország.
Orvosi hetilap
|June 22, 2025
概括
电心电图 (ECG) 异常常见于缩性心肌病 (HCM) 患者,通常呈异质. 识别这些多样化的心电图发现对于早期诊断和及时启动疾病修饰治疗至关重要.
科学领域:
- 心脏病学 心脏病学
- 临床电生理学 临床电生理学
- 心血管诊断心血管诊断服务
背景情况:
- 2023年欧洲心脏病学会的指导方针强调了诊断心肌病的多参数方法.
- 电心电图 (ECG) 是诊断高伤心肌病 (HCM) 的重要工具,仅在4-18%的患者中发现正常的ECG.
- 在HCM中,心电图偏差往往是非特异性的,需要详细分析.
研究的目的:
- 为了评估超性心肌病患者队列中的特定ECG特征.
- 评估多变性心肌病症中各种心电图标准的诊断效用.
- 为了将心电图发现与高压阻塞性心肌病与非阻塞性高压阻塞性心肌病相关联.
主要方法:
- 通过心磁共振和/或基因检测诊断的72名高伤心肌病患者的患者数据和初始心电图的回顾性分析.
- 在2023年11月至2024年9月期间,Gottsegen国家心血管中心心力衰竭门诊对患者进行了随访.
- 评估包括传导干扰,电压标准,Q波,QRS碎片,QT间隔,T波和ST段异常的分析.
主要成果:
- 观察到高频率的心电图异常,包括心房动 (6%),心房间导电障碍 (29%),心室/心室内导电障碍 (50%).
- 具体发现包括病态的Q波 (42%),QRS碎片 (43%),纠正的QT间隔延长 (44%) 和T波逆转 (94%).
- 高压标准 (康奈尔,索科洛里昂,佩格罗洛普雷斯蒂) 的灵敏度较低 (1425%),只有康奈尔标准在阻塞性和非阻塞性HCM之间显示出显著差异 (45%与15%,p=0.044).
结论:
- 多式联络诊断方法对于过度缩性心肌病仍然至关重要.
- 超性心肌病经常与多样化和异质性的心电图异常有关.
- 早期识别这些心电图变异可以帮助进一步的诊断步骤,并指导疾病修改治疗的启动.
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