Поражения сердца при нервно-мышечных заболеваниях у детей

Многие нервно-мышечные заболевания часто сочетаются с поражением миокарда. Среди наиболее распространенных из них – группа мышечных дистрофий. Дилатационная кардиомиопатия, желудочковые аритмии, фибрилляции предсердий, нарушения атриовентрикулярной и внутрижелудочковой проводимости, а также внезапная сердечная смерть – хорошо известные симптомы при мышечной дистрофии Дюшенна, миотонической дистрофии 1-го и 2-го типов, мышечной дистрофии Эмери–Дрейфуса и различных вариантах поясно-конечностных мышечных дистрофий. Выявление кардиальной патологии у данных групп пациентов возможно с помощью электрокардиографии, эхокардиографии и магнитно-резонансной томографии сердца, которые рекомендованы в рамках скринингового обследования и раннего кардиопротективного лечения.

1. Barp A., Bello L., Politano L. et al. Genetic modifiers of Duchenne muscular dystrophy and dilated cardiomyopathy. PLoS One 2015;10(10):1–14.

2. Ferlini A., Sewry C., Melis M.A. et al. X-linked dilated cardiomyopathy and the dystrophin gene. Neuromuscul Disord 1999;9:339–46.

3. Jefferies J.L., Eidem B.W., Belmont J.W. et al. Genetic predictors and remodeling of dilated cardiomyopathy in muscular dystrophy. Circulation 2005;112:2799–804.

4. Manzur A.Y., Muntoni F. Diagnosis and new treatments in muscular dystrophies. J Neurol Neurosurg Psychiatry 2009;80: 706–14.

5. Lodi R., Hart P.E., Rajagopalan B. et al. Antioxidant treatment improves in vivo cardiac and skeletal muscle bioenergetics in patients with Friedreich’s ataxia. Ann Neurol 2001;49(5):590–6.

6. Holaska J.M. Emerin and the nuclear lamina in muscle and cardiac disease. Circ Res 2008;103:16–23.

7. English K.M., Gibbs J.L. Cardiac monitoring and treatment for children and adolescents with neuromuscular disorders. Dev Med Child Neurol 2006;48:231–5.

8. Babuty D., Fauchier L., Tena-Carbi D. et al. It is possible to identify infrahissian cardiac conduction abnormalities in myotonic dystrophy by non-invasive methods? Heartt 1999;82:634–7.

9. Bhakta D., Lowe M.R., Groh W.J. Prevalence of structural cardiac abnormalities in patients with myotonic dystrophy type I. Am Heart J 2004;147:224–7.

10. Melacini P., Buja G., Fasoli G. et al. The natural history of cardiac involvement in myotonic dystrophy: an eight-year followup in 17 patients. Clin Cardiol 1988; 11:231–8.

11. Stollberger C., Winkler-Dworak M., Blazek G., Finsterer J. Association of electrocardiographic abnormalities with cardiac findings and neuromuscular disorders in left ventricular hypertrabeculation/non-compaction. Cardiology 2007;107:374–9.

12. Mertens L., Ganame J., Claus P. et al. Early regional myocardial dysfunction in young patients with Duchenne muscular dystrophy. J Am Soc Echocardiogr 2008;21:1049–54.

13. Silva M.C., Meira Z.M., Gurgel Giannetti J. et al. Myocardial delayed enhancement by magnetic resonance imaging in patients with muscular dystrophy. J Am Coll Cardiol 2007;49:1874–9.

14. Kazanegra R., Cheng V., Garcia A. et al. A rapid test for B-type natriuretic peptide correlates with falling wedge pressures in patients treated for decompensated heart failure: a pilot study J Card Fail 2001;7(1):21–9.

15. Remme W.J., Swedberg K. Guidelines for the diagnosis and treatment of chronic heart fealure. Task force for the diagnosis and treatment of chronic heart fealure, European Society of cardiology. Eur Heart J 2001;22(17):1527–60.

16. Verhaert D., Richards K., Rafael-Fortney J.A. Cardiac involvement in patients with muscular dystrophies. Magnetic imaging phenotype and genotypic considerations. Circ Cardiovasc Imaging 2011;4(1):67–76.

17. Архипова Е.Н., Родионова Т.В., Басаргина Е.Н. и др. Закономерности изменения содержания NT-proBNP в крови и их диагностическая значимость у детей с хронической сердечной недостаточностью. Вопросы диагностики в педиатрии. 2012;4(3):11–6. [Аrkhipovа Е.N., Rodionovа Т.V., Basargina Е.N. et al. Common factors of the change of NT-proBNP content in blood and its diagnostic value at children with chronic cardiac failure. Voprosy diagnostiki v pediatrii = Diagnostic Issues in Pediatrics 2012;4(3):11–6. (In Russ.)].

18. Ishikawa K. Cardiac involvement in progressive muscular dystrophy of the Duchenne type. Jpn Heart J 1997;38:163–80.

19. Thrush P.T., Allen H.D., Viollet L., Mendell J.R. Re-examination of the electrocardiogram in boys with Duchenne muscular dystrophy and correlation with its dilated cardiomyopathy. Am J Cardiol 2009;103:262–5.

20. Kirchmann C., Kececioglu D., Korinthenberg R., Dittrich S. Echocardiographic and electrocardiographic findings of cardiomyopathy in Duchenne and Becker-Kiener muscular dystrophies. Pediatr Cardiol 2005;26:66–72.

21. Klitzner T.S., Beekman R., Galioto F.M. et al. Cardiovascular health supervision for individuals affected by Duchenne or Becker muscular dystrophy. Pediatrics 2005;116: 1569–73.

22. Muntoni F. Cardiac complications of childhood myopathies. J Child Neurol 2003;18:191–202.

23. Bunse M., Bit-Avragim N., Riefflin A. et al. Cardiac energetics correlates to myocardial hypertrophy in Friedreich’s ataxia. Ann Neurol 2003;53(1):121–3.

24. Finsterer J., Stollberger C. Neuromuscular disorders associated with apical hypertrophic cardiomyopathy. Acta Cardiol 2009;64:85–9.

25. Басаргина Е.Н., Архипова Е.Н., Жарова О.П. Типичные ошибки при лечении хронической сердечной недостаточности со сниженной систолической функцией у детей. Фарматека 2014;(1): 55–62. [Basargina E.N., Arkhipova E.N., Zharova O.P. Typical errors in the treatment of chronic cardiac failure with diminished systolic function in children. Farmateka = Pharmatec 2014;(1):55–62. (In Russ.)].

26. Connuck D.M., Sleeper L.A., Colan S.D. et al. Characteristics and outcomes of cardiomyopathy in children with Duchenne or Becker muscular dystrophy: a comparative study from the Pediatric Cardiomyopathy Registry. Am Heart J 2008;155:998–1005.

27. Duboc D., Meune C., Pierre B. et al. Perindopril preventive treatment on mortality in Duchenne muscular dystrophy: 10 years’ followup. Am Heart J 2007;154: 596–602.

28. Rhodes J., Margossian R., Darras B.T. et al. Safety and efficacy of carvedilol therapy for patients with dilated cardiomyopathy secondary to muscular dystrophy. Pediatr Cardiol 2008;29:343–51.