Twenty-four-hour ambulatory ECG monitoring relevancy in myotonic dystrophy type 1 follow-up: Prognostic value and heart rate variability evolution.
Adult
Arrhythmias, Cardiac
/ diagnostic imaging
Case-Control Studies
Cause of Death
Death, Sudden, Cardiac
/ etiology
Defibrillators, Implantable
Electrocardiography
/ methods
Electrocardiography, Ambulatory
/ methods
Female
Heart Rate
/ physiology
Humans
Male
Middle Aged
Monitoring, Physiologic
/ methods
Myotonic Dystrophy
/ diagnostic imaging
Pacemaker, Artificial
Predictive Value of Tests
Prognosis
Retrospective Studies
Risk Assessment
Severity of Illness Index
Survival Analysis
Time Factors
Young Adult
Holter monitoring
ambulatory electrocardiography
autonomic nervous system
heart rate variability
myopathy
type 1 myotonic dystrophy
Journal
Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc
ISSN: 1542-474X
Titre abrégé: Ann Noninvasive Electrocardiol
Pays: United States
ID NLM: 9607443
Informations de publication
Date de publication:
01 2019
01 2019
Historique:
received:
09
04
2018
revised:
18
06
2018
accepted:
24
07
2018
pubmed:
14
8
2018
medline:
10
4
2020
entrez:
14
8
2018
Statut:
ppublish
Résumé
Patient prognosis in type 1 myotonic dystrophy (DM1) is very poor. Annual 24-hour holter ECG monitoring is recommended but its relevance is debated. Main objective was to determine whether holter ECG parameters could predict global death in DM1 patients and secondarily to assess whether they could predict cardiovascular events and sudden cardiac death, to compare DM1 patients and healthy controls, and to assess their evolution in DM1 over a 5-year period. This retrospective study included genetically confirmed DM1. Primary endpoint was global death. Secondary endpoints were labeled "sudden cardiac death" which was a composite of sudden cardiac death, aborted sudden cardiac death, implantable cardioverter defibrillator therapy, sustained ventricular tachycardia, atrioventricular block grade 3, pause >3 s; and "cardiovascular events" which was a composite of all-cause mortality, pacemaker or cardioverter defibrillator implantation, sustained ventricular tachycardia, supraventricular tachycardia, hospitalization for acute cardiac cause and heart failure. Forty-seven patients (22 women, 40 ± 13 years old) were included. Three (7%) DM1 patients died, 9 (19%) experienced "sudden cardiac death" endpoint and 21 (45%) experienced "cardiovascular event" endpoint during mean follow-up of 95 ± 22 months. None of holter ECG parameters were discriminant to predict death or secondary endpoints. Compared to healthy controls, DM1 patients had higher SDNN and LF/HF ratio. Finally, heart rate variability parameters remained stable over a mean interval of 61 ± 15 months excepting pNN50 which decreased significantly. Results suggest that annually-repeated holter ECG in DM1 is not useful for stratifying risk of sudden death and cardiovascular outcomes.
Sections du résumé
BACKGROUND
Patient prognosis in type 1 myotonic dystrophy (DM1) is very poor. Annual 24-hour holter ECG monitoring is recommended but its relevance is debated. Main objective was to determine whether holter ECG parameters could predict global death in DM1 patients and secondarily to assess whether they could predict cardiovascular events and sudden cardiac death, to compare DM1 patients and healthy controls, and to assess their evolution in DM1 over a 5-year period.
METHODS
This retrospective study included genetically confirmed DM1. Primary endpoint was global death. Secondary endpoints were labeled "sudden cardiac death" which was a composite of sudden cardiac death, aborted sudden cardiac death, implantable cardioverter defibrillator therapy, sustained ventricular tachycardia, atrioventricular block grade 3, pause >3 s; and "cardiovascular events" which was a composite of all-cause mortality, pacemaker or cardioverter defibrillator implantation, sustained ventricular tachycardia, supraventricular tachycardia, hospitalization for acute cardiac cause and heart failure.
RESULTS
Forty-seven patients (22 women, 40 ± 13 years old) were included. Three (7%) DM1 patients died, 9 (19%) experienced "sudden cardiac death" endpoint and 21 (45%) experienced "cardiovascular event" endpoint during mean follow-up of 95 ± 22 months. None of holter ECG parameters were discriminant to predict death or secondary endpoints. Compared to healthy controls, DM1 patients had higher SDNN and LF/HF ratio. Finally, heart rate variability parameters remained stable over a mean interval of 61 ± 15 months excepting pNN50 which decreased significantly.
CONCLUSION
Results suggest that annually-repeated holter ECG in DM1 is not useful for stratifying risk of sudden death and cardiovascular outcomes.
Identifiants
pubmed: 30101452
doi: 10.1111/anec.12587
pmc: PMC6931664
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e12587Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2018 Wiley Periodicals, Inc.
Références
Int J Cardiol. 2017 Sep 15;243:424-430
pubmed: 28550978
Europace. 2011 Feb;13(2):251-7
pubmed: 21113052
Acta Myol. 2007 Oct;26(2):112-4
pubmed: 18421899
Heart. 2002 Dec;88(6):665-70
pubmed: 12433913
Eur Heart J. 2014 Aug 21;35(32):2158-64
pubmed: 24742887
Ann Noninvasive Electrocardiol. 2019 Jan;24(1):e12587
pubmed: 30101452
Neuromuscul Disord. 2004 Feb;14(2):136-41
pubmed: 14733960
Am J Med. 1979 Sep;67(3):467-73
pubmed: 474592
Circulation. 1996 Mar 1;93(5):1043-65
pubmed: 8598068
J Auton Nerv Syst. 1995 Oct 5;55(1-2):131-4
pubmed: 8690846
J Am Coll Cardiol. 1988 Mar;11(3):662-71
pubmed: 3278037
Circulation. 1992 Jan;85(1):164-71
pubmed: 1728446
Am Heart J. 2010 Dec;160(6):1137-41, 1141.e1
pubmed: 21146669
Ann Noninvasive Electrocardiol. 2003 Jul;8(3):227-32
pubmed: 14510658
Arq Bras Cardiol. 2012 Apr;98(4):353-60
pubmed: 22406991
Int J Cardiol. 2015 Apr 1;184:600-608
pubmed: 25769007
Echocardiography. 2017 Feb;34(2):184-190
pubmed: 28191665
Eur Heart J. 2017 Mar 7;38(10):751-758
pubmed: 27941019