Familial cardiomyopathy--a 15-year follow-up.

European journal of cardiology Pub Date : 1980-01-01
M Rosenqvist, G Biörck, U de Faire, U Freyschuss, K Lindvall, B Magnusson
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Abstract

In 1961--1962 five families including 53 members with a familial form of cardiomyopathy (CMP) were examined. Fifteen years later a reinvestigation of the previously examined families was carried out using community registers; mortality as well as new family members were registered. Another 50 family members were thereby added. Three out of 6 young subjects who were diagnosed as having definite (2) or suspected (1) CMP at the initial examination died during the follow-up period. Four of the five families, totalling 39/41 members, were given a thorough noninvasive clinical examination including ECG, phonocardiogram exercise test, measurement of systolic time intervals and carotid arterial pulse curves, and echocardiography (Echo). A high number (17/39) of suspected or definite pathologic echocardiographic changes consistent with CMP was observed on reinvestigation. Eleven of these 17 were asymptomatic. Except for Echo, the non-invasive methods used in this study did not contribute to the diagnosis of CMP, but the non-Echo methods confirmed the Echo findings in those patients with symptoms of cardiac disease. The four reexamined families revealed a very heterogenous pattern of CMP, with both symmetric and asymmetric hypertrophy (ratio symmetric/asymmetric = 15 : 2). It may be questioned whether asymptomatic subjects with borderline changes, indicative of symmetric hypertrophy, will develop definite symmetric CMP or whether their symptoms constitute an early stage of asymmetric CMP. Echocardiographic findings may well fit with the theory of a dominant mode of inheritance.

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家族性心肌病,15年随访。
1961- 1962年,研究了5个家族,包括53名家族性心肌病(CMP)患者。15年后,利用社区登记册对先前调查的家庭进行了重新调查;对死亡率和新家庭成员进行了登记。因此又增加了50名家庭成员。在最初的检查中被诊断为明确(2)或疑似(1)CMP的6名年轻受试者中有3人在随访期间死亡。对5个家庭中的4个,共39/41名成员进行了全面的无创临床检查,包括心电图、心音图运动试验、收缩时间间隔和颈动脉脉搏曲线测量以及超声心动图(Echo)。再次调查时发现大量(17/39)疑似或明确的病理超声心动图改变与CMP一致。这17人中有11人无症状。除Echo外,本研究中使用的非侵入性方法对CMP的诊断没有帮助,但非Echo方法证实了有心脏病症状的患者的Echo结果。四个重新检查的家庭显示CMP的模式非常异质性,对称和不对称肥大(对称/不对称的比例= 15:2)。可能值得怀疑的是,无症状的边缘性改变,表明对称肥大,是否会发展为明确的对称CMP,或者他们的症状是否构成不对称CMP的早期阶段。超声心动图的发现可能很好地符合显性遗传模式的理论。
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