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[Cardiac disorders associated with progressive systemic sclerosis]
Insights
Progressive systemic sclerosis frequently causes cardiac disorders, including conduction abnormalities and valvular disease. Pericardial thickening is notably linked to positive anticardiolipin antibodies in these patients.
Area of Science:
- Cardiology
- Rheumatology
- Systemic Autoimmune Diseases
Context:
- Progressive systemic sclerosis (PSS) is a systemic autoimmune disease affecting multiple organs.
- Cardiac involvement is a significant complication of PSS, impacting patient prognosis.
- Previous studies highlight various cardiac manifestations, but specific associations require further investigation.
Purpose:
- To investigate the prevalence and types of cardiac disorders in patients diagnosed with progressive systemic sclerosis.
- To assess the relationship between cardiac abnormalities and clinical/serological findings, particularly anticardiolipin antibodies.
Summary:
- This study examined 25 female patients with PSS, mean age 59 years, mean disease duration 11 years.
- Abnormal electrocardiograms (ECG) were found in 44% and abnormal echocardiograms in 64%. Common ECG findings included conduction disturbances, while echocardiography revealed valvular diseases and pericardial thickening.
- Echocardiographic abnormalities, especially pericardial thickening (63%), were more frequent in patients with positive anticardiolipin antibodies compared to those with negative antibodies (12%, p < 0.05).
Impact:
- Identifies a high prevalence of cardiac disorders in PSS patients.
- Highlights the significant association between pericardial thickening and positive anticardiolipin antibody status.
- Suggests routine cardiac evaluation and monitoring for PSS patients, particularly those with specific serological markers.
Abstract:
This study investigated cardiac disorders in 25 patients with diagnoses of progressive systemic sclerosis based on the criteria of the American College of Rheumatology. All were women, and the mean age was 59 +/- 11 (range 41-80) years old. The duration of the disease was 11 +/- 9 (range 3-40) years. The following complications were seen; Raynaud's phenomenon in all, esophageal disorders in 11, pulmonary fibrosis in 9, diabetes mellitus in 3, high blood pressure in 6, hyperlipidemia in 7, and positive anticardiolipin antibody in 8. Electrocardiography (ECG) and echocardiography were performed to assess the cardiac disorders. Abnormal ECG was seen in 11 patients (44%) and abnormal echocardiograms in 16 patients (64%). ECG abnormalities included incomplete right bundle branch block in 8 (32%), low voltage in 3 (12%), supraventricular arrhythmia in 3 (12%), ventricular arrhythmia in 1 (4%) and septal myocardial infarction pattern in 1 (4%). Echocardiographic abnormalities included valvular diseases in 13 (52%) and pericardial thickening in 7 (28%). No relationship was found between ECG and echocardiographic abnormalities. Echocardiographic abnormalities were more frequently observed in patients with positive anticardiolipin antibody (7/8, 88%) than in those with negative anticardiolipin antibody (9/17, 53%). Especially, pericardial thickening was seen in 63% (5/8) of positive patients, in comparison to 12% (2/17) of the negative patients (p < 0.05). Patients with progressive systemic sclerosis may have several cardiac disorders including conduction disturbances, low voltage ECG, valvular diseases and pericardial thickening. Pericardial thickening has a close relationship with positive anticardiolipin antibody.