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Repolarization in systemic sclerosis: a meta-analysis.

Yehuda Wexler1, Udi Nussinovitch2

  • 1Rappaport Faculty of Medicine and Research Institute, Technion - Israel Institute of Technology, POB 9649, 3109601, HaifaHaifa, Israel.

Clinical Rheumatology
|November 29, 2021
PubMed
Summary
This summary is machine-generated.

Systemic sclerosis patients show a statistically significant increase in QTc duration compared to controls. However, the absolute QTc prolongation is not extreme, limiting its clinical utility for diagnosis and risk stratification.

Keywords:
ECGQTQTcRepolarizationSclerodermaSystemic sclerosis

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Area of Science:

  • Cardiology
  • Rheumatology
  • Medical Diagnostics

Background:

  • Systemic sclerosis (SSc) is a rare autoimmune disease affecting connective tissues, leading to immune dysregulation, vascular damage, and fibrosis.
  • Cardiac manifestations are frequent in SSc, contributing significantly to mortality.
  • Conflicting reports exist regarding QTc duration in SSc patients, necessitating a comprehensive review.

Purpose of the Study:

  • To systematically review and meta-analyze existing studies on QTc duration in SSc patients.
  • To determine if QTc duration can aid in the diagnosis and risk stratification of SSc.
  • To investigate correlations between comorbidities and QTc duration in SSc.

Main Methods:

  • A systematic search of PubMed and Embase databases was conducted for relevant case-control and cohort studies.
  • Studies published before March 1, 2021, were included.
  • A random-effects model was employed for meta-analysis, with heterogeneity testing and linear regression for comorbidity correlations.

Main Results:

  • Ten studies quantitatively analyzed QTc duration in SSc patients (mean 422.21 ms) versus controls (mean 411.43 ms).
  • A statistically significant increase in QTc duration was observed in SSc patients (SMD 0.59, p<0.01).
  • No significant correlation was found between SSc traits and QTc values; substantial heterogeneity existed between studies (I²=83%).

Conclusions:

  • Systemic sclerosis patients exhibit a statistically significant prolongation of the QTc interval.
  • The absolute QTc prolongation is modest, suggesting limited clinical utility for diagnosis or risk stratification.
  • Further large-scale prospective studies are warranted to clarify the clinical significance of QTc changes in SSc.