Nussinovitch Udi, Beeri Gil, Rubin Shiri, Lidar Merav, Levi Yair, Livneh Avi
Department 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.
Department of Cardiology, Meir Medical Center, Kfar Saba, Israel;Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Eur J Rheumatol. 2021 Jul;8(3):144-149. doi: 10.5152/eurjrheum.2020.19215.
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.
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.
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.
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.
系统性硬化症（SSc）与心脏发病率和死亡率的增加相关。SSc中某些心律失常的心电图标志物是否易导致早期心源性死亡仍存在争议。本研究评估了SSc患者中先前报道的以及未研究的复极标志物的发生情况，并评估了它们的预后意义。
本前瞻性研究共纳入21例SSc患者和31例未受影响的对照者。在严格标准下进行心电图检查。使用指定的计算机软件确定复极和离散参数以及晚期心室电位标志物。对多次心跳的结果进行平均。
SSc组和对照组在平均QT间期、平均校正QT间期、平均QT间期离散度（QTd）、平均QT校正离散度（QTcd）和QT离散率方面无显著差异。然而，SSc患者的平均QT顶点离散度、平均JT离散度、平均JT校正离散度和T峰 - T末校正值显著高于对照组。在SSc患者或对照组中均未发现晚期心室电位。在纳入研究前发生室性心律失常的1例患者中记录到QTd和QTcd增加。在9年随访期间，其余SSc患者或对照组均未发生心律失常。
SSc患者可能观察到复极参数异常。然而，在本研究中无法确定它们对于复极相关室性心律失常风险增加和心脏死亡增加的预后意义。我们的研究结果支持对此问题进行更多研究。
