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Hu Z, Wu L, Lin Z, Liu X, Zhao C, Wu Z. Prevalence and associated factors of Electrocardiogram abnormalities in patients with systemic lupus erythematosus: a machine learning study. Arthritis Care Res (Hoboken) 2021; 74:1640-1648. [PMID: 33787068 DOI: 10.1002/acr.24612] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/02/2021] [Accepted: 03/25/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVES Electrocardiogram (ECG) abnormalities are predictive of subsequent cardiovascular events. Cardiac involvement is common in systemic lupus erythematosus (SLE). We aimed to determine the prevalence of ECG abnormalities in SLE patients and to examine the factors associated with ECG abnormalities with machine learning approaches. METHODS Consecutive SLE patients' records were retrieved from the database of the hospital for the cross-sectional study. Abnormal ECGs with clinical significance were grouped into tachyarrhythmias, atrioventricular block, non-specific ST-segment changes, T-wave abnormalities, ventricular hypertrophy, axis deviation, bundle branch block, and QT interval prolongation. Associated factors of the most common ECG abnormalities were assessed by comparing logistic regression and four other machine learning approaches. RESULTS Two hundred ninety-nine patients were enrolled. One hundred twenty-eight out of them were clinically significant abnormalities. T-wave changes (52.3%), non-specific ST-T changes (26.6%), and prolonged QT interval (8.6%) were the most prevalent abnormalities among patients with abnormal ECG. Random forest models had the best performance in the discovery of associated factors. Age, disease duration, ANA titer, disease activity (SLEDAI-2K) were associated with non-specific ST-T changes, prolonged QT interval, and T-wave changes. Hypertension, positive anti-SSA, and secondary Sjögren syndrome were influential factors for non-specific ST-T changes, prolonged QT interval, and T-wave changes specifically. CONCLUSION ST-T changes/T-wave changes were the most common abnormalities seen in ECGs of SLE patients. Our finding suggests that age, longer disease duration, higher disease activity, hypertension, anti-SSA antibody positive, and secondary Sjögren syndrome are important, influential factors for these ECG abnormalities.
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Affiliation(s)
- Zhuoran Hu
- Division of Rheumatology, Third Affiliated Hospital of Sun Yat-sen University, Tianhe District, No.600, Tianhe Road, Guangzhou City, 51000, China
| | - Lin Wu
- Division of Cardiology, Third Affiliated Hospital of Sun Yat-sen University, Tianhe District, No.600, Tianhe Road, Guangzhou City, 51000, China
| | - Zhiming Lin
- Division of Rheumatology, Third Affiliated Hospital of Sun Yat-sen University, Tianhe District, No.600, Tianhe Road, Guangzhou City, 51000, China
| | - Xiuhua Liu
- Division of Rheumatology, Liuzhou Worker's Hospital (Fourth Affiliated Hospital of Guangxi Medical University, Yufeng District, ). No.1, Liushi Road, Liuzhou City, 545000, China
| | - Changlin Zhao
- Division of Cardiology, Third Affiliated Hospital of Sun Yat-sen University, Tianhe District, No.600, Tianhe Road, Guangzhou City, 51000, China
| | - Zhen Wu
- Division of Cardiology, Third Affiliated Hospital of Sun Yat-sen University, Tianhe District, No.600, Tianhe Road, Guangzhou City, 51000, China
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Azharudeen M, Thabah MM, Satheesh S, Negi VS. QT interval parameters, anti-Ro antibody status, and disease activity in systemic lupus erythematosus. J R Coll Physicians Edinb 2021; 50:380-386. [PMID: 33469612 DOI: 10.4997/jrcpe.2020.406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The QT interval a marker of ventricular depolarization and repolarization is reported to be prolonged in some proportion of patients with systemic lupus erythematosus (SLE). We studied electrocardiographic (ECG) abnormalities, in particular QT interval and its relationship with anti-Ro antibodies, disease activity, and serum interleukin 1β (IL-1β), interleukin 6 (IL-6) in SLE. METHODS A 12-lead resting ECG was performed on 140 adult SLE patients fulflling SLICC/ACR classification criteria. All patients received hydroxychloroquine and prednisolone. Corrected QT (QTc) °440 milliseconds (ms) was defined as prolonged QTc. QT dispersion (QTd) °60 ms was defined as increased QTd. RESULTS Eighty-four patients had some form of ECG abnormality. Prolongation of QTc and QTd was present in 24 (17.1%) and 50 (35.7%) respectively. Anti-Ro/SSA antibodies were present in 63 (45%). Prolongation of QTc in anti-Ro positive versus anti-Ro negative was 17.5% and 17% respectively, p=0.98. Prolongation of QTd in anti-Ro-positive versus anti-Ro-negative was 32% and 39% respectively, p=0.37. Prolonged QTc was observed in 15% patients with SLEDAI ˛4 compared to 17.5% patients with SLEDAI °5, p=0.78. The median serum concentrations of IL-1β and IL-6 were similar in the groups with and without prolonged QTc, with and without prolonged QTd. On binary logistic regression analyses neither clinical nor laboratory factors were predictors of prolonged QTc. However, having valvular regurgitation and hypercholesterolemia was associated with significantly reduced odds of having prolonged QTd, adjusted OR 0.33 (CI 0.14-0.83), p=0.018 and 0.19 (CI 0.05-0.80), p=0.023 respectively. Those with high LDL cholesterol and hypertriglyceridemia had a significantly higher odds of having a normal QTd with adjusted OR of 4.34 (1.31-14.46) p=0.017and 5.59 (1.62-19.38) p=0.007respectively. CONCLUSION Though 17% and 35% SLE patients have QTc and QTd prolongation, association with anti-Ro antibodies or disease activity was absent. A large proportion has other asymptomatic ECG abnormalities that may reflect subclinical cardiac involvement.
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Affiliation(s)
- Mohamed Azharudeen
- Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India
| | - Molly Mary Thabah
- Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER, Puducherry, India 605006, ;
| | | | - Vir Singh Negi
- Department of Clinical Immunology, JIPMER, Puducherry, India
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Bienias P, Ciurzyński M, Kisiel B, Chrzanowska A, Kalińska-Bienias A, Ciesielska K, Saracyn M, Lisicka M, Radochońska J, Pruszczyk P. Influence of disease severity and cardiac autonomic tone on ventricular repolarization and dispersion in electrocardiographic assessment of patients with systemic lupus erythematosus. Lupus 2020; 29:913-923. [DOI: 10.1177/0961203320928402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background There are no data on the influence of disease severity and cardiac autonomic tone on ventricular repolarization and dispersion in 24-hour Holter monitoring in systemic lupus erythematosus (SLE). Methods Consecutive 92 SLE and 51 healthy subjects were studied. The standard 12-lead electrocardiography (ECG), Holter monitoring with heart rate turbulence (HRT) and QT, Tp-e and Tp-e/QT ratio assessment (including corrected values) were performed. Subjects with conditions causing repolarization abnormalities or insufficient number of beats suitable for QT evaluation were excluded (17 SLE and 8 controls). Results Finally, 75 SLE and 43 sex- and age-matched controls were included to the study. In SLE patients, the median disease severity score (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR-DI)) was 3.0. The mean values of QTc, cTp-e and cTp-e/QTc were significantly higher in SLE patients than in controls. QTc ≥ 460 ms was observed in 18.7% of patients using standard ECG and in 58.7% using Holter monitoring. With Holter monitoring, patients with SLICC/ACR-DI >3.0 presented longer QTc than those with SLICC/ACR-DI ≤3.0 (418±15 vs. 409 ± 16, p = 0.04), while cTp-e and cTp-e/QTc values were similar. Patients with abnormal HRT presented longer cTp-e and higher cTp-e/QTc than those with normal HRT (92 ± 52 vs. 71 ± 16 ms, p = 0.04; 0.244 ± 0.126 vs. 0.187 ± 0.035, p = 0.03), while QTc values were similar. No differences in QT and Tp-e parameters were observed according to disease duration. Conclusion In SLE patients, Holter monitoring revealed QTc prolongation more frequently than standard ECG. Longer QTc values were observed in patients with more advanced disease, while increased cTp-e and cTp-e/QTc were related to cardiac autonomic dysfunction expressed by abnormal HRT.
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Affiliation(s)
- Piotr Bienias
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Michał Ciurzyński
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Bartłomiej Kisiel
- Department of Internal Diseases and Rheumatology, Military Institute of Medicine, Warsaw, Poland
| | - Anna Chrzanowska
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland
| | | | - Katarzyna Ciesielska
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Marek Saracyn
- Department of Internal Diseases, Nephrology and Dialysis, Military Institute of Medicine, Warsaw, Poland
| | - Monika Lisicka
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Joanna Radochońska
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Pruszczyk
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland
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Moghadam EA, Hamzehlou L, Moazzami B, Mehri M, Ziaee V. Increased QT Interval Dispersion is Associated with Coronary Artery Involvement in Children with
Kawasaki Disease. Oman Med J 2020; 35:e88. [PMID: 31993226 PMCID: PMC6975257 DOI: 10.5001/omj.2020.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 04/01/2019] [Indexed: 11/03/2022] Open
Abstract
Objectives Coronary artery (CA) involvement is the most well known complication of Kawasaki disease (KD). Previous studies have suggested that QT dispersion has a predictive value in diagnosing cardiac ischemia, ventricular arrhythmia, and sudden cardiac death. However, limited data exits regarding the application of QT dispersion in KD. Therefore, we sought to determine whether there is a relationship between QT dispersion and CA involvement in patients with KD. Methods We performed a cross-sectional study of all consecutive patients with KD who were followed-up at the Pediatric Rheumatology Department (Pediatrics Center of Excellence affiliated to Tehran University of Medical Sciences, Tehran, Iran) from September 2013 to November 2015. Patients who met the criteria for KD, based on the American Heart Association guideline, were enrolled in the study. We collected data regarding patients' demographics, clinical manifestations, laboratory, and echocardiographic findings. Results A total of 70 KD patients were identified, including 43 males (61.4%) and 27 females (38.6%). The median age of patients was 21.0 (11.0-48.0) months. We found statistically significant differences between age, gender, and platelet count among patients with and without CA involvement (p < 0.050). Median corrected QT dispersion in patients with CA involvement calculated from 12 leads in the acute phase was significantly higher compared to the non-CA involvement group (108.0 (89.5-138.5) ms vs. 63.0 (54.0-74.5) ms, respectively (p < 0.001)). Conclusions Prolonged QT dispersion (corrected or non-corrected) during the acute and convalescence phases in patients with KD is associated with coronary involvement.
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Affiliation(s)
- Ehsan Aghaei Moghadam
- Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran.,Children's Medical Center, Pediatrics Center of Excellence, Tehran, Iran
| | - Leila Hamzehlou
- Children's Medical Center, Pediatrics Center of Excellence, Tehran, Iran
| | - Bobak Moazzami
- Children's Medical Center, Pediatrics Center of Excellence, Tehran, Iran
| | - Mina Mehri
- Children's Medical Center, Pediatrics Center of Excellence, Tehran, Iran
| | - Vahid Ziaee
- Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran.,Children's Medical Center, Pediatrics Center of Excellence, Tehran, Iran.,Pediatric Rheumatology Research Group, Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Shukla AM, Wagle Shukla A. Expanding horizons for clinical applications of chloroquine, hydroxychloroquine, and related structural analogues. Drugs Context 2019; 8:2019-9-1. [PMID: 31844421 PMCID: PMC6905642 DOI: 10.7573/dic.2019-9-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 10/08/2019] [Accepted: 10/09/2019] [Indexed: 12/11/2022] Open
Abstract
Several experimental and clinical studies have transformed the traditional antimalarial role of chloroquine (CHQ) and related structural analogues to potent therapeutic agents for a host of nonmalarial indications. The expanding clinical applicability for these drugs includes rheumatological and cardiovascular disorders (CVD), chronic kidney disease (CKD), oncology, and a variety of nonmalarial infections. These clinical advancements are primarily related to pleiotropic pharmacological actions of these drugs, including immunomodulation, anti-inflammatory properties, and capabilities of inducing autophagy and apoptosis at a cellular level. Historically, many clinical benefits in nonmalarial indications were first recognized through serendipitous observations; however, with numerous ongoing systematic clinical studies, the clinical horizons of these drugs have a promising future.
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Affiliation(s)
- Ashutosh M Shukla
- North Florida/South Georgia, Veteran Healthcare System, Gainesville, FL, USA
- Department of Medicine, Division of Nephrology, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Aparna Wagle Shukla
- Department of Neurology, College of Medicine, University of Florida, Gainesville, FL, USA
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Bazyar Z, Moaref A, Amirghofran AA, Nazarinia M, Kojuri J. A Woman with Systemic Lupus Erythematosus and Odd Valvular Presentation: A Case Report. AMERICAN JOURNAL OF CASE REPORTS 2019; 20:1705-1708. [PMID: 31740655 PMCID: PMC6878967 DOI: 10.12659/ajcr.917743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Systemic lupus erythematosus (SLE) is a systemic disease with various cardiac and non-cardiac presentations. We present the case of a young woman with odd presentation of SLE mistakenly identified as a valve abscess that was scheduled for surgery. CASE REPORT This 35-year-old woman presented with rapid progression of aortic stenosis, and the transesophageal echocardiography report showed a misdiagnosed aortic web (congenital) and aortic wall abscess. She was scheduled for surgery as a case of subacute bacterial endocarditis (SBE) and aortic abscess, despite lack of fever. CONCLUSIONS Cardiovascular involvement should be considered in any SLE patient, especially those with high SLE scores, even with negative antiphospholipid antibody. Cardiovascular involvement may be odd and misleading in some cases, which may warrant especial attention and experienced caregivers for clinical reasoning and proper management.
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Affiliation(s)
- Zohre Bazyar
- Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Moaref
- Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mohammadali Nazarinia
- Shiraz Geriatric Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Javad Kojuri
- Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Shiraz Geriatric Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Harada M, Motoki H, Kashima Y, Nakamura C, Hashizume N, Kishida D, Imamura H, Kuwahara K. T-wave alternans in a case with systemic lupus erythematosus-related myocarditis. J Cardiol Cases 2018; 18:119-122. [PMID: 30279927 DOI: 10.1016/j.jccase.2018.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 05/17/2018] [Accepted: 05/24/2018] [Indexed: 10/28/2022] Open
Abstract
A 42-year-old woman presented with fever, dyspnea, lower-leg edema, significant pulmonary congestion, pleural effusion, and severely reduced left ventricular contractions. She was resistant to treatment for heart failure, including catecholamines, furosemide, phosphodiesterase III inhibitors, and human atrial natriuretic peptide, and antibiotics failed to reduce her inflammation. She had renal dysfunction and hypocomplementemia and was positive for anti-nuclear and anti-ds-DNA antibodies. The patient was diagnosed with myocarditis and pleurisy associated with systemic lupus erythematosus (SLE). Prednisolone administration improved her general condition, reducing inflammation and improving left ventricular function. On day 1, an electrocardiography (ECG) revealed a T-wave inversion similar to a T-U complex configuration in leads II, aVF, and V3-6. By day 8, however, ECG showed prolonged corrected QT (QTc) and T-wave alternans (alternating beat-to-beat T-wave patterns) in lead V3-6. Careful ECG monitoring should be used to identify potentially fatal ventricular arrhythmias during the recovery phase of SLE-related myocarditis. <Learning objective: This was a case of significant T-wave alternans (TWA) during recovery from systemic lupus erythematosus (SLE)-related myocarditis. Fatal ventricular arrhythmia appears to be a risk during recovery from myocardial damage caused by SLE. Up to now, there have been no published case reports of TWA during this period. Patients with myocarditis should be carefully monitored for arrhythmia, even after ventricular function and inflammation have improved with prednisolone therapy.>.
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Affiliation(s)
- Mikiko Harada
- Department of Cardiovascular Medicine, Shinshu University School of Medicine, Nagano, Japan
| | - Hirohiko Motoki
- Department of Cardiovascular Medicine, Shinshu University School of Medicine, Nagano, Japan
| | - Yuichiro Kashima
- Department of Emergency and Critical Care Medicine, Shinshu University School of Medicine, Nagano, Japan
| | - Chie Nakamura
- Department of Cardiovascular Medicine, Shinshu University School of Medicine, Nagano, Japan.,Department of Cardiology, Ina Central Hospital, Nagano, Japan
| | - Naoto Hashizume
- Department of Cardiovascular Medicine, Shinshu University School of Medicine, Nagano, Japan
| | - Dai Kishida
- Department of Neurology and Rheumatology, Shinshu University School of Medicine, Nagano, Japan
| | - Hiroshi Imamura
- Department of Emergency and Critical Care Medicine, Shinshu University School of Medicine, Nagano, Japan
| | - Koichiro Kuwahara
- Department of Cardiovascular Medicine, Shinshu University School of Medicine, Nagano, Japan
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Motoki N, Akazawa Y, Yamazaki S, Hachiya A, Motoki H, Matsuzaki S, Koike K. Prognostic Significance of QT Interval Dispersion in the Response to Intravenous Immunoglobulin Therapy in Kawasaki Disease. Circ J 2017; 81:537-542. [PMID: 28154289 DOI: 10.1253/circj.cj-16-0864] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Kawasaki disease (KD) is classified as a systemic vasculitis syndrome and QT interval dispersion (QTD) has been associated with cardiac involvement and disease activity in patients with cardiovasculitis. We examined whether baseline QTD could predict a response to intravenous immunoglobulin (IVIG) in KD.Methods and Results:QTD was recorded in 86 patients with KD before IVIG, who were separated into IVIG responders (R group; n=62) and nonresponders (N group; n=24). The association between baseline QTD and response to IVIG was investigated, and the predictive response value was compared with conventional risk scores from Gunma and Kurume universities. Baseline-corrected QTDs with Bazett's (QTbcD) and Fridericia's (QTfcD) formulae were significantly increased in the N group (R group vs. N group: 31.6 [28.3, 44.0] ms vs. 66.6 [50.5, 76.3] ms and 27.4 [25.2, 39.1] ms vs. 55.2 [42.4, 66.3] ms, respectively, both P<0.001). Multiple logistic regression analysis revealed QTfcD as an independent predictor of a response to IVIG after adjustment for conventional scores (odds ratio: 1.133, 95% confidence interval: 1.061-1.210, P<0.001). Moreover, QTfcD provided incremental predictive value for IVIG nonresponders over Gunma score (increment in global χ2=25.46, P<0.001). CONCLUSIONS QTD was significantly associated with a response to IVIG in KD patients and may represent a useful identifier of IVIG nonresponders with high risk of coronary aneurysm.
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Affiliation(s)
- Noriko Motoki
- Department of Pediatrics, Shinshu University School of Medicine
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9
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Geraldino-Pardilla L, Gartshteyn Y, Piña P, Cerrone M, Giles JT, Zartoshti A, Bathon JM, Askanase AD. ECG non-specific ST-T and QTc abnormalities in patients with systemic lupus erythematosus compared with rheumatoid arthritis. Lupus Sci Med 2016; 3:e000168. [PMID: 28079193 PMCID: PMC5174789 DOI: 10.1136/lupus-2016-000168] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Revised: 10/29/2016] [Accepted: 09/03/2016] [Indexed: 12/29/2022]
Abstract
Objectives Cardiovascular disease (CVD) is a leading cause of death in systemic lupus erythematosus (SLE) and in rheumatoid arthritis (RA). Although only explored in one study, ECG non-specific ST-T abnormalities, in addition to corrected QT-interval (QTc) prolongation, were recently reported in an SLE inception cohort. Importantly, these ECG abnormalities are known predictors of CVD mortality in the general population, yet their prevalence in patients with established SLE has not been evaluated. Methods We cross-sectionally investigated the presence of non-specific ST-T and QTc abnormalities in 50 patients with SLE, predominantly Hispanic and black, without CVD or SLE-related cardiac involvement and compared them with 139 patients with RA without CVD. Demographics, disease-specific characteristics and CVD risk factors were ascertained and adjusted for. Results Patients with SLE (mean age 36±13 years, 92% women, 6 years median disease duration, 96% Hispanics and blacks) had a 3.3-fold higher adjusted prevalence of non-specific ST-T abnormalities (56% vs 17%; p <0.0001) compared with RA, despite the older age and higher percentage of men in the RA group. The QTc was 26 ms longer in SLE compared with RA (p=0.002) in the setting of a higher percentage of women, blacks, Hispanics and higher C reactive protein levels in the SLE group. Conclusions This study demonstrates a high prevalence of ECG abnormalities in predominantly Hispanic and black patients with SLE. Longitudinal evaluation of the progression to potentially life-threatening arrhythmias and/or cardiovascular events is warranted.
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Affiliation(s)
| | - Yevgeniya Gartshteyn
- Columbia University, College of Physicians & Surgeons , New York, New York , USA
| | - Paloma Piña
- Northwestern University , Chicago, Illinois , USA
| | - Marina Cerrone
- New York University (NYU) School of Medicine , New York, New York , USA
| | - Jon T Giles
- Columbia University, College of Physicians & Surgeons , New York, New York , USA
| | - Afshin Zartoshti
- Columbia University, College of Physicians & Surgeons , New York, New York , USA
| | - Joan M Bathon
- Columbia University, College of Physicians & Surgeons , New York, New York , USA
| | - Anca D Askanase
- Columbia University, College of Physicians & Surgeons , New York, New York , USA
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Sham S, Madheshwaran M, Tamilselvam TN, Rajeswari S. Correlation of QT interval with disease activity in newly detected SLE patients at baseline and during flare. INDIAN JOURNAL OF RHEUMATOLOGY 2015. [DOI: 10.1016/j.injr.2015.03.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Demır K, Avcı A, Yılmaz S, Demır T, Ersecgın A, Altunkeser BB. Fragmented QRS in patients with systemic lupus erythematosus. SCAND CARDIOVASC J 2014; 48:197-201. [DOI: 10.3109/14017431.2014.935801] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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12
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Avci A, Demir K, Altunkeser BB, Yilmaz S, Yilmaz A, Ersecgin A, Demir T. Assessment of inhomogeneities of repolarization in patients with systemic lupus erythematosus. Ann Noninvasive Electrocardiol 2014; 19:374-82. [PMID: 24597863 PMCID: PMC6932449 DOI: 10.1111/anec.12145] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES Systemic lupus erythematosus (SLE) is a chronic disease that affects many organ systems and manifests a broad spectrum of laboratory and clinical features. SLE patients have an increased risk of developing cardiovascular disease. The aim of this study was to evaluate inhomogeneities of repolarization by using Tpeak -Tend (Tp-e) interval and Tp-e/QT ratio were measured from the 12-lead surface electrocardiogram (ECG) in patients with SLE. MATERIAL AND METHOD This study included 69 SLE patients (69 females; mean age 35.8 ± 10.2) and 57 control subjects (57 females; mean age 34.5 ± 8.9). Transthoracic echocardiographic examination was done in all participants. QT parameters, Tp-e intervals and Tp-e/QT ratio were measured from the 12-lead ECG. These parameters were compared between groups. RESULTS No statistically significant difference was found between two groups in terms of basic characteristics. Diastolic function parameters were similar between the two groups (P > 0.05). In electrocardiographic parameters analysis, QT dispersion (QTd) and corrected QT dispersion (cQTd) were significantly increased in SLE patients compared the control group (49.5 ± 16.4 ms vs. 32.8±11.7 ms and 56.7 ± 19.5 ms vs. 36.4 ± 13.1 ms, all P value < 0.001). Tp-e interval and Tp-e/QT ratio were also significantly higher in SLE patients (82.8 ± 18.9 vs. 72.4 ± 17.6 and 0.22 ± 0.05 vs. 0.19 ± 0.05, P = 0.002 and P = 0.001, respectively). Tp-e interval and Tp-e/QT were positively correlated with disease duration (r = 0.29, P = 0.01 and r = 0.24, P = 0.04, respectively). CONCLUSION Our study revealed that QTd, cQTd, Tp-e interval and Tp-e/QT ratio increased in patients with SLE. Also, Tp-e interval and Tp-e/QT were positively correlated with disease duration.
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Affiliation(s)
- Ahmet Avci
- Faculty of MedicineCardiology DepartmentSelcuk UniversityKonyaTurkey
| | - Kenan Demir
- Faculty of MedicineCardiology DepartmentSelcuk UniversityKonyaTurkey
| | | | - Sema Yilmaz
- Faculty of MedicineRheumatology DepartmentSelcuk UniversityKonyaTurkey
| | - Ahmet Yilmaz
- Faculty of MedicineCardiology DepartmentSelcuk UniversityKonyaTurkey
| | - Ahmet Ersecgin
- Faculty of MedicineCardiology DepartmentSelcuk UniversityKonyaTurkey
| | - Tarik Demir
- Faculty of Medicine, Internal Medicine DepartmentSelcuk UniversityKonyaTurkey
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Habib HM, Arafat WR, Marie MA, Eissa AA. Pulmonary involvement in early systemic lupus erythematosus. THE EGYPTIAN RHEUMATOLOGIST 2013. [DOI: 10.1016/j.ejr.2013.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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14
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Alkmim Teixeira R, Borba EF, Pedrosa A, Nishioka S, Viana VST, Ramires JA, Kalil-Filho R, Bonfa E, Martinelli Filho M. Evidence for cardiac safety and antiarrhythmic potential of chloroquine in systemic lupus erythematosus. Europace 2013; 16:887-92. [DOI: 10.1093/europace/eut290] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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