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Repolarization dispersion in patients with systemic sclerosis
Udi Nussinovitch1, Gil Beeri2, Shiri Rubin3
1Department of Cardiology, Meir Medical Center, Kfar Saba, Israel;Applicative Cardiovascular Research Center (ACRC), Meir Medical Center, Kfar Saba, Israel;Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Insights
Systemic sclerosis patients show abnormal repolarization markers, but their link to arrhythmias and cardiac death risk needs more study. Further research is recommended for these electrocardiographic findings.
Area of Science:
- Cardiology
- Rheumatology
- Electrophysiology
Background:
- Systemic sclerosis (SSc) is linked to higher rates of heart problems and death.
- The role of specific electrocardiographic (ECG) markers in predicting early cardiac death in SSc patients is debated.
Purpose of the Study:
- To investigate repolarization markers in SSc patients.
- To assess the prognostic value of these ECG markers for arrhythmias and cardiac death.
Main Methods:
- A prospective study included 21 SSc patients and 31 controls.
- Standardized ECGs were analyzed for repolarization and dispersion parameters using specialized software.
- Multiple beat averaging was employed for data analysis.
Main Results:
- SSc patients had significantly higher average QT apex dispersion, JT dispersion, JT corrected dispersion, and Tpeak-Tend corrected compared to controls.
- No significant differences were found in average QT intervals, corrected QT intervals, QT interval dispersion (QTd), or QT corrected dispersion (QTcd).
- Late ventricular potentials were absent; one SSc patient with prior arrhythmia showed increased QTd and QTcd, but no arrhythmias occurred during follow-up.
Conclusions:
- Certain abnormal repolarization parameters are present in SSc patients.
- The prognostic significance of these findings for ventricular arrhythmias and cardiac death remains undetermined.
- Additional research is necessary to clarify the clinical implications of these ECG abnormalities in SSc.
Objective:
Systemic sclerosis (SSc) is associated with increased cardiac morbidity and mortality. Whether some electrocardiographic markers of arrhythmias predispose to early cardiogenic death in SSc remains controversial. This study evaluated the occurrence of previously reported as well as unstudied markers of repolarization in patients with SSc and assessed their prognostic implications.
Methods:
A total of 21 patients with SSc and 31 unaffected controls were included in this prospective study. Electrocardiograms were conducted under strict standards. Repolarization and dispersion parameters and markers of late ventricular potentials were determined using designated computer software. Results of multiple beats were averaged.
Results:
There were no significant differences between the SSc and control groups in average QT intervals, average corrected QT intervals, average QT interval dispersion (QTd), average QT corrected dispersion (QTcd), and QT dispersion ratio. However, average QT apex dispersion, average JT dispersion, average JT corrected dispersion, and Tpeak-Tend corrected were significantly higher in patients with SSc than in controls. Late ventricular potentials were not found in patients with SSc or in controls. Increased QTd and QTcd were recorded in 1 patient who experienced ventricular arrhythmia before inclusion in the study. None of the remaining patients with SSc or the controls developed arrhythmia during the 9-year follow-up.
Conclusion:
Abnormal repolarization parameters may be observed in patients with SSc. However, their prognostic significance with regard to increased risk for repolarization-associated ventricular arrhythmias and increased cardiac death could not be determined in this study. Our findings endorse additional studies on this matter.
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