Abstract：ObjectiveTo explore the value of ECG in spotting sarcomere mutation carriers with family hypertrophic cardiomyopathy (FHCM) at an early phase.MethodsWe selected 60 FHCM patients’ relatives carrying sarcomere mutations but not complicating left ventricular hypertrophy as gene positive/phenotype negative group(G+/P－ group) while 73 FHCM patients’ relatives without carrying sarcomere mutation or left ventricular hypertrophy were considered as gene negative/phenotype negative group(G－/P－ group or control group). The G+/P－ group and control group were well matched in sex and age. Conventional 12lead ECG indexes were analyzed between the two groups. The efficacy of ECG parameters in diagnosing FHCM sarcomere mutation carriers was evaluated by the receiver operating characteristic curve(ROC) analysis. Results(ⅰ) The QRS duration of lead Ⅰ, aVR and aVF, and Rwave amplitude in lead V1 and V2 in G+/P－ group were significantly higher than those in control group(P<0.05); in G+/P－ group, Rwave amplitude in lead V4-V6 were significantly lower if compared with the control group(P<0.05). (ⅱ) The proportion of Twave changes(including Twave flatness, inversion and bidirection) in G+/P－ group was significantly higher than that in the control group (28.3% vs. 19.2%, P<0.05). There was no statistically significant difference of SokolowLyon voltage index(SV1+ RV5 or RV6≥3.5 mV), abnormal Qwave and the proportion of fragmented QRS wave between the two groups(P>0.05). ConclusionAmong the FHCM patients carrying sarcomere mutation, ECG changes are manifested by the prolongation of QRS duration, amplitude variation of Rwave in chest leads and Twave changes at an early phase, which are valuable for making early diagnosis for these patients.
张娟, 刘丽文, 朱晓丽, 王博, 杨倩利, 邵虹, 张国庆, 左蕾, 雷常慧, 徐磊, 李静, 张艳敏, 张军. 心电图对家族性肥厚型心肌病肌小节突变基因携带者早期诊断的价值[J]. 实用心电学杂志, 2018, 27(6): 386-391.
ZHANG Juan, LIU Li-Wen, ZHU Xiao-Li, WANG Bo, YANG Qian-Li, SHAO Hong, ZHANG Guo-Qing, ZUO Lei, LEI Chang-Hui, XU Lei, LI Jing, ZHANG Yan-Min, ZHANG Jun. The early diagnostic value of ECG for sarcomere mutation carriers with family hypertrophic cardiomyopathy. JOURNAL OF PRACTICAL ELECTROCARDIOLOGY, 2018, 27(6): 386-391.
2018, Vol. 27 
