Factors Associated with Electrocardiographic Alterations in Myotonic Dystrophy type 1

Authors

Keywords:

myotonic dystrophy type 1, conduction disturbances, arrhythmias, cardiac ischaemia.

Abstract

Introduction: Myotonic dystrophy type 1 is a multisystem genetic disorder. Cardiac involvement is frequent and includes different electrocardiographic alterations.

Objective: To identify factors associated with electrocardiographic abnormalities in myotonic dystrophy type 1.

Methods: A retrospective case-control study was conducted in Pinar del Río from January 2019 to August 2022 in 81 people with the disease and 162 healthy controls. Multiple variables were analysed: age, sex, personal history of chronic diseases, dyslipidemias, body mass index and electrocardiographic alterations. Data processing was performed with the SPSS statistical package.

Results: Underweight and electrocardiographic abnormalities were associated with disease (OR = 7.551 and OR = 2.306) respectively. Factors associated with atrioventricular and intraventricular conduction disturbances included: age greater than or equal to 40 years (OR = 4.870), normal weight with OR = 6.400, and male and female sex with OR = 2.106 and OR = 2.558. For electrocardiographic signs of cardiac ischaemia, age greater than or equal to 40 years increased the risk up to 12.288 times; female sex was another factor associated with a risk of 18.839 times.

Conclusions: There are factors that, when associated, increase the risk of electrocardiographic alterations. These factors include age greater than or equal to 40 years, female sex and a history of other chronic diseases.

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References

Sánchez-Tejerina D, Palomino Doza J, Valverde-Gómez M, Ruiz-Curiel A, Salguero-Bodes R, Hernández-Voth A, et al. Distrofia miotónica de tipo 1: una serie de 107 pacientes. Rev Neurol. 2021 [acceso 20/05/2021];73:351-7. Disponible en: https://www.neurologia.com/articulo/2021366

Grijalba Ipinazar I, Tuduri Limousinb I, Reguera Fernández M, Najarro Ajuriaa G, Martínez Ruiz A. Manejo anestésico en un niño con síndrome de Steinert congénito programado para orquidopexia bilateral por laparoscopia. Rev Esp de Anestesiol Reanim. 2019 [acceso 20/05/2021];66(7):381-4. Disponible en: https://pesquisa.bvsalud.org/portal/resource/pt/ibc-187551

Itoh H, Hisamatsu T, Tamura T, Segawa K, Takahashi T, Takada H, et al. Cardiac Conduction Disorders as Markers of Cardiac Events in Myotonic Dystrophy Type 1. J Am Heart Assoc. 2020 [acceso 20/05/2021];9(17):e015709. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7660777/

Lau JK, Sy RW, Corbett A, Kritharides L. Myotonic dystrophy and the heart: A systematic review of evaluation and management. International Journal of Cardiology. 2015 [acceso 20/05/2021];184(2015):600-8. Disponible en: https://pubmed.ncbi.nlm.nih.gov/25769007/

Russo V, Sperlongano S, Gallinoro E, Rago A, Papa AA, Golino P, et al. Prevalence of Left Ventricular Systolic Dysfunction in Myotonic Dystrophy Type 1: A Systematic Review. J Card Fail. 2020 [acceso 20/05/2021];26(10):849-56. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31415861/

Rosado-Bartolomé A, Gutiérrez-Gutiérrez G. Distrofia miotónica de Steinert y enfermedad tromboembólica. Rev Neurol. 2022 [acceso 20/05/2021];74(11):372-3. Disponible en: https://neurologia.com/articulo/2022129

Enterat.com. Tabla de IMC 2022 de la OMS (mujeres y hombres adultos); 2022 [acceso 20/05/2021]. Disponible en: https://www.enterat.com/salud/imc-indice-masa-corporal.php

World Medical Association. Declaration of Helsinki. Ethical Principles for Medical Research Involving Human Subjects. Fortaleza, Brasil: 64ª Asamblea General; 2013 [acceso 20/5/2022]. Disponible en: https://www.wma.net/wp-content/uploads/2016/11/DoH-Oct2013-JAMA.pdf

Gutiérrez Gutiérrez G, Díaz-Manerab J, Almendrotec M, Azrield S, Eulalio Bárcenae J, Cabezudo García P, et al. Guía clínica para el diagnóstico y seguimiento de la distrofia miotónica tipo 1, DM1 o enfermedad de Steinert. Neurol. 2020 [acceso 16/11/2022];35(3):185-206. Disponible en: https://www.elsevier.es/es-revista-neurologia-295-articulo-guia-clinica-el-diagnostico-seguimiento-S0213485319300192

Freyermuth F, Rau F, Kokunai Y, Linke T, Sellier C, Nakamori M, et al. Splicing misregulation of SCN5A contributes to cardiac-conduction delay and heart arrhythmia in myotonic dystrophy. Nat Commun. 2016 [acceso 16/11/2022];7:11067. Disponible en: https://www.nature.com/articles/ncomms11067.pdf

McNally E, Mann DL, Pinto Y, Bhakta D, Tomaselli G, Nazarian S, et al. Clinical Care Recommendations for Cardiologists Treating Adults with Myotonic Dystrophy. J Am Heart Assoc. 2020 [acceso 16/11/2022];9(4):e014006. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7070199/

Salazar V, Renato M, Antonio D. Afectación cardíaca en pacientes con distrofia miotónica tipo 1 atendidos en el Instituto Nacional de Ciencias Neurológicas, período 1995-2017 [Trabajo de investigación]. Universidad Peruana Cayetano Heredia; 2018 [acceso 16/11/2022]. Disponible en: https://repositorio.upch.edu.pe/bitstream/handle/20.500.12866/3550/Afectacion_VelitSalazar_Mario.pdf?sequence=1&isAllowed=y

Gamet A, Degand B, Le Gal F, Bidegain N, Delaubier A, Gilbert‐Dussardier B, et al. Twenty‐four‐hour ambulatory ECG monitoring relevancy in myotonic dystrophy type 1 follow‐up: Prognostic value and heart rate variability evolution. Ann Noninvasive Electrocardiol. 2019 [acceso 16/11/2022];24(1):e12587. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6931664/

Russo V, Papa AA, Lioncino M, Rago A, Di Fraia F, Palladino A, et al. Prevalence of atrial fibrillation in myotonic dystrophy type 1: A systematic review. Neuromuscular Disorders. 2021 [acceso 16/11/2022];31(4):281-90. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0960896621000031

Wahbi K, Furling D. Cardiovascular manifestations of myotonic dystrophy. Trends Cardiovasc Med. 2020 [acceso 16/11/2022];30(4):232-8. Disponible en: https://www.sciencedirect.com/science/article/pii/S105017381830224X?via%3Dihub

Petri H, Vissing J, Witting N, Bundgaard H, Køber L. Cardiac manifestations of myotonic dystrophy type 1. International Journal of Cardiology. 2012 [acceso 16/11/2022];160(2):82-8. Disponible en: https://pubmed.ncbi.nlm.nih.gov/21917328/

Ha AH, Tarnopolsky MA, Bergstra GT, Nair GM, Al-Qubbany A, Healey JS. Predictors of atrio-ventricular conduction disease, long-term outcomes in patients with myotonic dystrophy types I and II. Pacing Clin Electrophysiol. 2012 [acceso 16/11/2022];35(10):1262-9. Disponible en: https://pubmed.ncbi.nlm.nih.gov/22385162/

Russo V, Rago A, Atripaldi L, Leonardi S, Papa AA, Politano L, et al. SERUM cardiac-specific biomarkers and atrial fibrillation in myotonic dystrophy type I. J Cardiovasc Electrophysiol. 2019 [acceso 16/11/2022];30(12):2914-19. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31579995/

Nikhanj A, Sivakumaran S, Yogasundaram H, Becher H, Kimber S, Siddiqi ZA, et al. Comparison of usefulness of cardiac resynchronization therapy in patients with type 1 myotonic dystrophy with versus without left bundle branch block. Am J Cardiol. 2019 [acceso 16/11/2022];124(11):1770-4. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31586533/

Chmielewski L, Bietenbeck M, Patrascu A, Rösch S, Sechtem U, Yilmaz A, et al. Non-invasive evaluation of the relationship between electrical and structural cardiac abnormalities in patients with myotonic dystrophy type 1. Clin Res Cardiol. 2019 [acceso 16/11/2022];108:857-67. Disponible en: https://link.springer.com/article/10.1007/s00392-019-01414-0

Russo V. Editorial commentary: myotonic dystrophy: the "right weapons" to fight the long battle against sudden cardiac death. Trends Cardiovasc Med. 2020;30(4):239-40. DOI: https://doi.org/10.1016/j.tcm.2019.07.003

Navarrete W, Armijo G, Aguayo R, Cisternas C. Taquicardia ventricular como expresión de Distrofia Miotónica tipo 1. Rev Chil Cardiol. 2017 [acceso 16/11/2022];36(3):239-43. Disponible en: https://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0718-85602017000300239&lng=es

Otsubo T, Tsuchiya T, Yamaguchi T, Takahashi N. Left atrial low-voltage zone ablation of persistent atrial fibrillation in a patient with myotonic dystrophy: a case report. J Arrhythm. 2018 [acceso 16/11/2022];34:302-4. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6009765/pdf/JOA3-34-302.pdf

Spaziani M, Semeraro A, Bucci E, Rossi F, Garibaldi M, Papassifachis MA, et al. Hormonal and metabolic gender differences in a cohort of myotonic dystrophy type 1 subjects: a retrospective, case-control study. J Endocrinol Invest. 2020;43:663-75. DOI: https://doi.org/10.1007/s40618-019-01156-w

Hernández Rodríguez J, Domínguez Yuri A, Moncada Espinal OM. Prevalencia y tendencia actual del sobrepeso y la obesidad en personas adultas en el mundo. Rev Cubana Endocrinol. 2019 [acceso 25/05/2022];30(3):e193. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1561-29532019000300009&lng=es

Rivas Estany E, de la Noval García R. Obesidad en Cuba y otras regiones del Mundo. Consideraciones generales y acciones nacionales de prevención. Anales de la Academia de Ciencias de Cuba. 2021 [acceso 12/09/2022];11(1). Disponible en: http://www.revistaccuba.cu/index.php/revacc/article/view/887/1037

Fonte Medina NC, Llanes Lobo J, Bencomo Fonte LM, Pérez Álvarez Y, Fonseca Medina Y. Marcadores aterogénicos y síndrome metabólico en la población urbana pinareña de adultos mayores. Rev Ciencias Médicas. 2019 [acceso 12/09/2022];23(1):79-89. Disponible en: http://revcmpinar.sld.cu/index.php/publicaciones/article/view/3785

Published

2024-08-30

How to Cite

1.
Licourt Otero D, Pérez González H, Orraca Castillo M, Fernández Cueto JA, Torres González S, Sandrino Sánchez M. Factors Associated with Electrocardiographic Alterations in Myotonic Dystrophy type 1. Rev. cuba. cardiol. cir. cardiovasc. [Internet]. 2024 Aug. 30 [cited 2025 Mar. 10];30:e2188. Available from: https://revcardiologia.sld.cu/index.php/revcardiologia/article/view/2188

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