Electrocardiographic features of disease progression in arrhythmogenic right ventricular cardiomyopathy/dysplasia

BMC Cardiovascular Disorders

Firat Duru⁴  Corinna Brunckhorst³  Felix C Tanner⁴  Thomas F Lüscher⁴  Nazmi Krasniqi³  Jan Steffel³  Laurent M Haegeli³  Thomas Wolber⁴  Arhan R Saguner³  Deniz Akdis³  Samuel H Baldinger²  Andrea Kraus¹  Sabrina Ganahl³  Ardan M Saguner³ 

[1] Division of Biostatistics, Institute for Social and Preventive Medicine, University Zurich, Zurich, Switzerland;Department of Cardiology, University Hospital Bern, Bern, Switzerland;Department of Cardiology, University Heart Center Zurich, Rämistrasse 100, CH-8091 Zurich, Switzerland;Center for Integrative Human Physiology, University Zurich, Zurich, Switzerland

关键词: T wave inversion;    Electrocardiography;    Dysplasia;    Cardiomyopathy;    Arrhythmogenic Right Ventricular;   

Others  :  1114633
DOI  :  10.1186/1471-2261-15-4

 received in 2014-11-10, accepted in 2015-01-09,  发布年份 2015

【 摘 要 】

Background

Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is considered a progressive cardiomyopathy. However, data on the clinical features of disease progression are limited. The aim of this study was to assess 12-lead surface electrocardiographic (ECG) changes during long-term follow-up, and to compare these findings with echocardiographic data in our large cohort of patients with ARVC/D.

Methods

Baseline and follow-up ECGs of 111 patients from three tertiary care centers in Switzerland were systematically analyzed with digital calipers by two blinded observers, and correlated with findings from transthoracic echocardiography.

Results

The median follow-up was 4 years (IQR 1.9–9.2 years). ECG progression was significant for epsilon waves (baseline 14% vs. follow-up 31%, p = 0.01) and QRS duration (111 ms vs. 114 ms, p = 0.04). Six patients with repolarization abnormalities according to the 2010 Task Force Criteria at baseline did not display these criteria at follow-up, whereas in all patients with epsilon waves at baseline these depolarization abnormalities also remained at follow-up. T wave inversions in inferior leads were common (36% of patients at baseline), and were significantly associated with major repolarization abnormalities (p = 0.02), extensive echocardiographic right ventricular involvement (p = 0.04), T wave inversions in lateral precordial leads (p = 0.05), and definite ARVC/D (p = 0.05).

Conclusions

Our data supports the concept that ARVC/D is generally progressive, which can be detected by 12-lead surface ECG. Repolarization abnormalities may disappear during the course of the disease. Furthermore, the presence of T wave inversions in inferior leads is common in ARVC/D.

【 授权许可】

   
2015 Saguner et al.; licensee BioMed Central.

【 图 表 】

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