Notched T wave as evidence of autonomic nervous lability in Duchenne progressive muscular dystrophy

We investigated the significance of notched T waves on the ECG in 30 patients with Duchenne progressive muscular dystrophy (DMD) and 50 agematched controls using noninvasive cardiovascular examinations and measurement of urinary catecholamines. Notched T waves were more frequently observed in patients with DMD than in control subjects (46.7% vs. 20.0%, p<0.05). Moreover, their frequency was ageindependent in DMD, whereas they decreased with age in controls. Patients with notched T waves showed significantly increased heart rate, prolonged QTc and augmented excretion of urinary adrenaline compared with patients without them. There were no significant differences in casual BP or incidences of characteristic UCG abnormalities, such as mitral valve prolapse, and ECG abnormalities, such as tall R waves in the right precordial leads, between DMD patients with and without notched T waves. These findings suggest that notched T waves are associated with accelerated sympathetic nervous activity rather than progressive cardiac involvement in DMD.