title: Abnormal signal-averaged electrocardiogram in patients with Duchenne muscular dystrophy: comparison of time and frequency domain analyses from the signal-averaged electrocardiogram.
abstract: The clinical significance of an abnormal signal-averaged electrocardiogram (SA-ECG) in time- and frequency-domain analyses was assessed in patients with Duchenne muscular dystrophy (DMD). Twenty-four DMD patients and 20 age-matched healthy volunteers were studied. The SA-ECG was recorded by time-domain signal processing using the vector-magnitude method and frequency-domain signal processing using the fast-Fourier transform. Abnormal SA-ECGs were based on comparison with controls and eight abnormal SA-ECGs were detected among 24 DMD patients, seven by frequency-domain analysis and four by time-domain analysis. The end-diastolic left ventricular volume was larger in the patients with abnormal SA-ECG than in those with normal SA-ECG (136 +/- 32 ml vs. 77 +/- 43 ml, p < 0.01). Compared with patients with normal SA-ECGs, the DMD patients with abnormal SA-ECGs had a lower left ventricular (LV) ejection fraction (54 +/- 6 vs. 61 +/- 8%, p < 0.05), as an index of LV contractility, and less LV posterior wall velocity (46 +/- 9 mm/min vs. 62 +/- 16 mm/min, p < 0.01), as an index of LV relaxation. The sensitivity and specificity of frequency-domain analysis for predicting malignant ventricular arrhythmias was 60 and 85%, respectively, compared with 30 and 92%, respectively, for time-domain analysis. The combination of time- and frequency-domain analyses can facilitate identification of DMD patients with ventricular tachyarrhythmias associated with depression of cardiac performance.
authors.affiliation: Department of Pediatrics, School of Medicine, University of Tokushima, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Kubo
authors.forename: S
authors.initials: S
authors.lastname: Matsuoka
authors.forename: Y
authors.initials: Y
authors.lastname: Hayabuchi
authors.forename: H
authors.initials: H
authors.lastname: Akita
authors.forename: Y
authors.initials: Y
authors.lastname: Matsuka
authors.forename: Y
authors.initials: Y
authors.lastname: Kuroda
mesh_terms: D000293:Adolescent; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D004562:Electrocardiography / Q000379:methods*; D005583:Fourier Analysis; D006801:Humans; D008297:Male; D009136:Muscular Dystrophies / Q000150:complications*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted; D013318:Stroke Volume / Q000502:physiology; D017180:Tachycardia, Ventricular / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D016277:Ventricular Function, Left / Q000502:physiology