【罂粟摘要】围产期心肌病的心电图特征及其超声心动图的相关性：来自ESC EORP PPCM登记的结果
围产期心肌病的心电图特征及其超声心动图的相关性：来自ESC EORP PPCM登记的结果
目的：围产期心肌病(PPCM)患者的心电图(ECG)及其与超声心动图的关系，尚未在大型多中心、多民族的研究中得到证实；研究目的旨在确认具有区域和种族差异性的PPCM患者的异常心电图与超声心动图特征的相关性。
方法和结果：研究纳入来自欧洲心脏病学会登记处的411名PPCM患者，收集基线人口统计学资料，临床及超声心动图数据；中位年龄为31岁[四分位数范围(IQR)26-35岁]，PPCM患者心电图异常率＞95%，并分析心电图的心率、节律、QRS宽度和形态及QTc间期；常见为窦性心动过速(心率>100次/分)，占51%，其中左束支传导阻滞(LBBB)发生率为9.30%，而房颤少见，仅占2.27%；QRS宽度中位数为82毫秒[IQR 80-97]。根据心电图诊断标准，非洲人(59.62%)和亚洲人(23.17%)左心室肥厚的发生率高于白种人(7.63%，P<0.001)，但超声心动图与左心室肥厚无关。左室舒张末期内径(LVEDD)中位数为60 mm[IQR 55~65]，左室射血分数(LVEF)中位数为32.5%[IQR 25~39]，无明显地区或种族差异。窦性心动过速与LVEF<0.35%(OR1.85[95%CI1.20~2.85]，P=0.006)相关。预测LVEDD>55mm的心电图特征包括QRS波>120ms(OR11.32[95%CI1.52~84.84]，P=0.018)、LBBB(OR4.35[95%CI1.30~14.53]，P值=0.0.017)、左室肥厚(OR2.03[95%CI1.13~3.64]，P值=0.0.017)。
结论：PPCM患者常有心电图异常,窦性心动过速预示心脏收缩功能差，而QRS增宽、LBBB和LVH与左心室扩张相关。
Electrocardiographic features and their echocardiographic correlates in peripartum cardiomyopathy: results from the ESC EORP PPCM registry
Abstract
Aims: In peripartum cardiomyopathy (PPCM), electrocardiography (ECG) and its relationship to echocardiography have not yet been investigated in large multi-centre and multi-ethnic studies. We aimed to identify ECG abnormalities associated with PPCM, including regional and ethnic differences, and their correlation with echocardiographic features.
Methods and results: We studied 411 patients from the EURObservational PPCM registry. Baseline demographic, clinical, and echocardiographic data were collected. ECGs were analysed for rate, rhythm, QRS width and morphology, and QTc interval. The median age was 31 [interquartile range (IQR) 26-35] years. The ECG was abnormal in > 95% of PPCM patients. Sinus tachycardia (heart rate > 100 b.p.m.) was common (51%), but atrial fibrillation was rare (2.27%). Median QRS width was 82 ms [IQR 80-97]. Left bundle branch block (LBBB) was reported in 9.30%. Left ventricular (LV) hypertrophy (LVH), as per ECG criteria, was more prevalent amongst Africans (59.62%) and Asians (23.17%) than Caucasians (7.63%, P < 0.001) but did not correlate with LVH on echocardiography. Median LV end-diastolic diameter (LVEDD) was 60 mm [IQR 55-65] and LV ejection fraction (LVEF) 32.5% [IQR 25-39], with no significant regional or ethnic differences. Sinus tachycardia was associated with an LVEF < 35% (OR 1.85 [95% CI 1.20-2.85], P = 0.006). ECG features that predicted an LVEDD > 55 mm included a QRS complex > 120 ms (OR 11.32 [95% CI 1.52-84.84], P = 0.018), LBBB (OR 4.35 [95% CI 1.30-14.53], P = 0.017), and LVH (OR 2.03 [95% CI 1.13-3.64], P = 0.017).
Conclusions: PPCM patients often have ECG abnormalities. Sinus tachycardia predicted poor systolic function, whereas wide QRS, LBBB, and LVH were associated with LV dilatation.
翻译：吴学艳 编辑：佟睿 审校：曹莹
贵州医科大学 高鸿教授课题组