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QT-interval parameters are increased in systemic lupus erythematosus patients
C R L Cardoso1, M A O Sales, J A S Papi
1Department of Internal Medicine, Clementino Fraga Filho University Hospital, Medical School, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. claudiacardoso@hucff.ufrj.br
Insights
Systemic lupus erythematosus (SLE) patients exhibit prolonged QT-interval parameters, indicating heightened cardiovascular risk. These findings suggest potential subclinical atherosclerotic cardiovascular disease in SLE patients.
Area of Science:
- Cardiology
- Rheumatology
- Electrocardiography
Background:
- Systemic lupus erythematosus (SLE) is associated with increased cardiovascular morbidity and mortality.
- QT-interval parameters are recognized markers of cardiovascular risk.
- Previous evaluations of QT-interval parameters in SLE patients are lacking.
Purpose of the Study:
- To evaluate QT-interval parameters (QTcmax and QTd) in female SLE outpatients.
- To compare these parameters with age- and BMI-matched healthy controls.
- To identify factors associated with QT-interval prolongation in SLE.
Main Methods:
- Standard 12-lead ECGs were performed on 140 female SLE patients and 37 controls.
- QT interval was measured, and heart rate-corrected maximum QT-interval duration (QTcmax) and QT-interval dispersion (QTd) were calculated.
- Clinical data, cardiovascular risk factors, lupus disease activity, and damage were recorded.
Main Results:
- SLE patients demonstrated significantly increased QTcmax and QTd compared to controls (P < 0.001 for both).
- These differences remained significant even after excluding patients with hypertension, diabetes, or ECG abnormalities (P = 0.041 for QTcmax, P = 0.001 for QTd).
- ECG-LVH, ST-T abnormalities, and left atrial enlargement were associated with QTcmax; age, ECG-LVH, and ST-T abnormalities were associated with QTd.
Conclusions:
- SLE patients exhibit prolonged QT-interval parameters, suggesting an elevated cardiovascular risk.
- This prolongation may be attributed to subclinical atherosclerotic cardiovascular disease in SLE.
- QT-interval parameters warrant further investigation as potential biomarkers for cardiovascular risk in SLE.
Abstract:
Systemic lupus erythematosus (SLE) patients have increased cardiovascular morbidity and mortality. QT-interval parameters are presumed markers of cardiovascular risk and have not been previously evaluated in SLE. Standard 12-lead ECGs were obtained from 140 female SLE outpatients and 37 age and body mass index-matched controls. QT interval was measured in each lead and heart rate-corrected maximum QT-interval duration (QTcmax) and QT-interval dispersion (QTd) were calculated. Risk factors for cardiovascular disease and lupus clinical features, disease treatment, disease activity and damage index were recorded. SLE patients have increased QT-interval parameters when compared to controls (QTcmax: 427.91 +/- 31.53 ms(1/2) versus 410.05 +/- 15.45 ms(1/2), P < 0.001; QTd: 52.38 +/- 22.21 ms versus 37.12 +/- 12.88 ms, P < 0.001). These differences persisted after excluding those patients with arterial hypertension, diabetes and with ECG abnormalities (QTcmax: 419.90 +/- 28.78 ms(1/2) versus 409.15 +/- 15.85 ms(1/2), P = 0.041; QTd: 54.74 +/- 26.00 ms versus 37.96 +/- 13.05 ms, P = 0.001). Multivariate linear regression for factors associated with QTcmax selected the presence of electrocardiographic left ventricular hypertrophy (ECG-LVH) (P = 0.003), nonspecific ST-T-wave abnormalities (P = 0.022) and left atrial enlargement (P = 0.044). Multivariate associates with QTd were age (P = 0.018), ECG-LVH (P = 0.022) and ST-T abnormalities (P = 0.031). In conclusion, SLE patients have increased QT interval parameters when compared to controls. This prolongation may lead to an increased cardiovascular risk. This finding might be due to subclinical atherosclerotic cardiovascular disease.
