Yavuz Bunyamin, Atalar Enver, Karadag Omer, Tulumen Erol, Ozer Necla, Akdogan Ali, Ertenli Ihsan, Kiraz Sedat, Calguneri Meral, Ozmen Ferhan
Department of Cardiology, Faculty of Medicine, Hacettepe University, 06100, Sihhiye , Ankara, Turkey.
Clin Rheumatol. 2007 Mar;26(3):376-9. doi: 10.1007/s10067-006-0364-5. Epub 2006 Aug 2.
Although autopsy studies have documented that heart is affected in most of systemic lupus erythematosus (SLE) patients, clinical manifestations occur in less than 10%. QT dispersion, a new parameter that can be used to assess homogeneity of cardiac repolarization and autonomic function, has not been studied in SLE patients. The aim of our study was to evaluate the QT dispersion (QTd) in SLE patients without overt cardiac involvement. Eighty-three patients with a diagnosis of SLE (mean age 41+/-13) and age- and sex-matched 77 healthy control subjects (mean age 43+/-10) were enrolled in the study. All subjects had their complete history taken, laboratory examination, and transthoracic echocardiography (ECG). Patients with cardiac disease, hypertension, diabetes, or taking medications that may effect QTd or any ECG abnormalities were excluded. Resting 12-lead ECG were recorded for measurement of QTd. None of the patients and control subjects had overt cardiac involvement. The mean SLE duration was 86.5+/-15.4 months. QT dispersion was significantly greater in SLE patients than incontrol subjects (55.2+/-24.7 vs 20.7+/-5.3 ms, respectively; p<0.001). There was no correlation between QTd and duration of SLE, SLEDAI-K score, corticosteroid usage, and presence of anti SS-A antibody. QT dispersion is significantly increased in SLE patients without overt cardiac involvement. Our result suggests that prolonged QT dispersion can be a useful noninvasive and simple method for early detection of cardiac involvement in SLE patients.
尽管尸检研究已证明大多数系统性红斑狼疮(SLE)患者的心脏会受到影响,但临床表现的发生率不到10%。QT离散度是一种可用于评估心脏复极均匀性和自主神经功能的新参数,尚未在SLE患者中进行研究。我们研究的目的是评估无明显心脏受累的SLE患者的QT离散度(QTd)。本研究纳入了83例诊断为SLE的患者(平均年龄41±13岁)以及77例年龄和性别匹配的健康对照者(平均年龄43±10岁)。所有受试者均进行了完整的病史采集、实验室检查和经胸超声心动图(ECG)检查。排除患有心脏病、高血压、糖尿病或正在服用可能影响QTd或任何心电图异常药物的患者。记录静息12导联心电图以测量QTd。患者和对照者均无明显心脏受累。SLE的平均病程为86.5±15.4个月。SLE患者的QT离散度显著高于对照者(分别为55.2±24.7与20.7±5.3毫秒;p<0.001))。QTd与SLE病程、SLEDAI-K评分、皮质类固醇使用情况及抗SS-A抗体的存在均无相关性。无明显心脏受累的SLE患者的QT离散度显著增加。我们的结果表明,QT离散度延长可能是早期检测SLE患者心脏受累的一种有用的非侵入性简单方法。