| Background:In recent year,more and more report about patient with pre-excitation,which can provoke LVDys and dilated without tachyarrhythmia.But the special mechanism of electrical machinery is still unknown.And not all the patient with Wolff-Parkinson-White syndrome are left ventricular dysfunction or dilated cardiomypathy.Aim:To investigate the incidence of pre-excited cardiomyopathy and to explore the possible risk factors of pre-excited cardiomyopathy in patients with WPW.Methods:93 patients with Wolff-Parkinson-White syndrome presenting to the First Affiliated Hospital of Nanjing Medical University were enrolled into the registry from September 2009 to March 2017.Analysis the feature of echocardiography and electrocardiogram recordings prior and after radiofrequency ablation.Clear the location of accessory pathway in surgery,carries on the correlation research.Results:A total of 85 patients with Wolff-Parkinson-White syndrome were enrolled into the registry。23 cases are type A Wolff-Parkinson-White syndrome,62 cases are type B Wolff-Parkinson-White syndrome.25 cases had echocardiographic abnormalities,21 are type B,4 are type A.22 cases had abnormal septal wall motion,3 are type A,19 are type B.There are 17 patient with pre-excitation dilated cardiomyopathy,14 are type B,3 are type A.Although type B WPW has more echocardiographic abnormalities than type B,but there was no statistically significant difference between the two groups.Determine the location of accessory pathway in surgery.Patients with right ventricular septal pathway had the highest rates of echocardiographic abnormalities,abnormal wall motion,and pre-excitation cardiomyopathy than other pathway,lowest incidence in left free wall group.A wider QRS wave(138.23±24.68 VS 118.00±19.27ms,P=0.001)and larger area of QRS wave(179.70±67.55 VS 139.05±47.54mm2,P=0.015)were seen in the patients with type B pre-excitation than those with type A pre-excitation.The wider and large QRS was found in patient with cardiac abnomalities.The width and area of QRS may have some relationship with abnomal septal wall motion.Patients with septal wall motion abnormalities have a smaller eiection fraction(53.33±10.76 VS 61.93±4.87,P<0.001)and larger left ventricular end diastolic(36.57±7.77 VS 30.28±4.08mm,P=0.002).Cardiac dysfunction with larger LVDs and LVDd is related to abnormal septal wall motion.The EF value is negatively correlated with the QRS wave width(r=,-0.327,P=0.002),and also negatively correlated with the QRS wave integral(r=-0.328,P=0.002).After radiofrequency ablation,abnormal wall motion disappeared in 1 patient.Type B patients have sone change in LA(31.86±4.02 VS 30.40±4.77)、LVDd(47.62±5.10 VS 46.02±4.91)and LVDs(32.08±6.34 VS 30.75±5.64).The EF increased slightly,but change is not statistically significant.Conclusion:Preexcitation syndrome may cause a part of patients with abnormal wall motion and cardiac dilatation,QRS width、QRS area、right septal accessory pathway may be relevant predictors of preexcitation cardiomyopathy.LA,LVDd and LVDs can be significantly reduced after ablation,but the EF has no obvious change,and the abnormal septal wall motion is not obvious improvement. |
