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QT dispersion and cardiac involvement in patients with juvenile idiopathic arthritis

Bülent Koca1, Ozgür Kasapçopur, Süleyman Bakari

  • 1Department of Pediatric Cardiology, Cerrahpasa Medical Faculty, İstanbul University, Istanbul, Turkey. bkoca78@yahoo.com

Rheumatology International
|September 28, 2011
PubMed

Insights

Juvenile idiopathic arthritis (JIA) in children does not show abnormal QT dispersion, a marker of heart rhythm. However, some patients exhibited early signs of diastolic dysfunction, indicating potential cardiac changes.

Area of Science:

  • Pediatric Rheumatology
  • Cardiology
  • Clinical Electrophysiology

Background:

  • Juvenile idiopathic arthritis (JIA) is a common childhood chronic inflammatory arthritis.
  • Cardiac involvement, including pericarditis and myocarditis, is recognized in JIA.
  • Left ventricular (LV) systolic and diastolic functions in pediatric JIA patients are understudied.
  • QT dispersion (QTd) is a noninvasive marker for cardiac repolarization homogeneity and arrhythmogenicity, previously unexamined in JIA.

Purpose of the Study:

  • To assess QT dispersion (QTd) and corrected QT dispersion (cQTd) in children with JIA.
  • To evaluate the relationship between QTd/cQTd and LV systolic/diastolic function in pediatric JIA.
  • To investigate potential arrhythmogenic markers in children with JIA.

Main Methods:

  • Electrocardiography (ECG) and Doppler echocardiography were performed on JIA patients and controls.
  • Measurements included QTmax, QTmin, QTd, corrected QT, cQTmax, cQTmin, and cQTd.
  • Echocardiography assessed LV systolic and diastolic parameters, including flow velocities and relaxation times.

Main Results:

  • No statistically significant differences in QTd or cQTd were observed between JIA patients and controls.
  • Children with JIA showed abnormal diastolic function, characterized by increased late flow velocity, decreased early flow velocity, and prolonged isovolumic relaxation time.
  • No ventricular arrhythmias were documented in either group during the 12-month follow-up.

Conclusions:

  • QTd and cQTd do not appear to be significantly altered in children with JIA.
  • Pediatric JIA patients may exhibit subclinical diastolic dysfunction.
  • Further research is needed to understand the long-term cardiac implications of diastolic dysfunction in JIA.

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