Alterações do eletrocardiograma e arritimias estão fortemente associadas ao desenvolvimento de cardiomiopatias na distrofia muscular de Duchenne

USA - os autores avaliaram 150 pacientes com diversas formas de distrofia muscular com o objetivo de avaliar se o eletrocardiograma e o holter são úteis na avaliação da presença ou não de doença cardíaca; alterações do eletrocardiograma foram observadas em 65% dos pacientes e se relacionou fortemente com a presença de miocardiopatia; somente 8% dos pacientes com eletrocardiograma normal apresentavam miocardiopatia. As alterações do eletrocardiograma são precoces e podem preceder em anos o aparecimento dos sintomas. A utilização do eletrocaridiograma e holter periódicos dos pacientes pode ajudar no diagnóstico precoce.

O resumo em inglês pode ser lido abaixo:

(Heart Rhythm, 2010) Electrocardiographic Abnormalities and Arrhythmias are Strongly Associated with the Development of Cardiomyopathy in Muscular Dystrophy

Anjan M. Shah, John L. Jefferies, Joseph W. Rossano, Jamie A. Decker, Bryan C. Cannon, Jeffrey J. Kim - USA

Objective: Assess the utility of electrocardiography in patients with muscular dystrophy. Background: Dilated cardiomyopathy is a well-recognized sequela of muscular dystrophy (MD). Early identification of cardiac involvement with timely therapy can favorably impact outcome. We hypothesize that electrocardiography can be a useful adjunct in the identification of DCM in MD. Methods: A retrospective review of patients with MD was performed. ECGs and Holters were analyzed to assess for association between abnormalities and the development of DCM. Results: One-hundred-fifty patients were identified. Forty-three percent of patients
(64/150) developed DCM. ECG abnormalities were found in 65% of patients and correlated well with the presence of DCM with 60/64 (94%) with DCM having an abnormal ECG vs. 38/86 (44%) without DCM (p<0.001). Only 4/52 (8%) of patients with normal ECGs had DCM. The presence of ECG abnormalities was highly sensitive (95.8%) but not specific (40.1%) to the presence of DCM. ECG abnormalities often preceded the development of DCM by a significant period of time (3.7+/-2.6 years). Arrhythmias were common with 17/150 (11%) of the cohort being affected. Those with DCM were significantly more likely to have an arrhythmia with 16/64 (25%) of that group being affected (p < 0.01). The presence of VT was a poor prognostic indicator with 6/11 patients dying within 0.68+/-0.41 years. Conclusions: ECG abnormalities are strongly associated with DCM in patients with MD
and frequently precede cardiac dysfunction by several years. Arrhythmias are common and periodic ECG and Holter evaluations are warranted as they may predict early cardiac involvement.

Fonte: http://distrofiamuscular.net/noticias.htm