Characterization of the electrocardiographic pattern of individuals with cerebral palsy

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• 作者：Carlos Alberto Pastore MD ; PhD ; ^a ; ^{ecg_pastore@incor.usp.br} ; Nelson Samesima MD^a ; Rodrigo Imada MD^a ; Marta Reis MD^a ; Maria Teresa Santos MD ; PhD^a ; Maria Cristina Ferreira MD ; PhD^a ; Cesar Grupi MD ; PhD^a ; Fernanda Fumagalli MD^a ; Jaqueline Wagenfuhr MD ; PhD^a ; Maira Chammas MD^a
• 关键词：Cerebral palsy ; Electrocardiography ; ECG parameters
• 刊名：Journal of Electrocardiology
• 出版年：2011
• 出版时间：March-April 2011
• 年：2011
• 卷：44
• 期：2
• 页码：138-141
• 全文大小：207 K

文摘

Background

Dentists of Lar São Francisco observed during dental treatment that children with cerebral palsy (CP) had increased heart rate (HR) and lower production of saliva. Despite the high prevalence of CP found in the literature (2.08-3.6/1000 individuals), little is known about the electrocardiographic (ECG) characteristics, especially HR, of individuals with CP.

Objective

This study aimed to investigate the hypothesis that individuals with CP have a higher HR and to define other ECG characteristics of this population.

Methods

Ninety children with CP underwent clinical examination and 12-lead rest ECG. Electrocardiographic data on rhythm, HR, PR interval, QRS duration, P/QRS/T axis, and QT, QTc and T_peak-end intervals (minimum, mean, maximum, and dispersion) were measured and analyzed then compared with data from a control group with 35 normal children. Fisher and Mann-Whitney U tests were used, respectively, to compare categorical and continuous data.

Results

Groups cerebral palsy and control did not significantly differ in age (9 ± 3 × 9 ± 4 years) and male gender (65 % × 49 % ). Children with CP had a higher HR (104.0 ± 20.6 × 84.2 ± 13.3 beats per minute; P < .0001), shorter PR interval (128.8 ± 15.0 × 138.1 ± 15.1 milliseconds; P = .0018), shorter QRS duration (77.4 ± 8.6 × 82.0 ± 8.7 milliseconds; P = .0180), QRS axis (46.0° ± 26.3° × 59.7° ± 24.8°; P = .0024) and T-wave axis (34.3° ± 28.9° × 42.9° ± 17.1°; P = .034) more horizontally positioned, and greater mean QTc (418.1 ± 18.4 × 408.5 ± 19.4 milliseconds; P = .0110). All the electrocardiogram variables were within the reference range for the age group including those with significant differences.

Conclusion

Children with CP showed increased HR and other abnormal ECG findings in the setting of this investigation. Further studies are needed to explain our findings and to correlate the increased HR with situations such as dehydration, stress, and autonomic nervous disorders.