Department of Emergency Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary.
Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary.
Int J Mol Sci. 2024 Jul 5;25(13):7380. doi: 10.3390/ijms25137380.
In systemic sclerosis (SSc), fibrosis of the myocardium along with ongoing autoimmune inflammation can alter the electric function of the cardiac myocytes, which may increase the risk for ventricular arrhythmias and sudden cardiac death. We analyzed the electrocardiographic (ECG) variables describing ventricular repolarization such as QT interval, QT dispersion (QTd), T wave peak-to-end interval (Tpe), and arrhythmogeneity index (AIX) of 26 patients with SSc and 36 healthy controls. Furthermore, echocardiographic and laboratory parameters were examined, with a focus on inflammatory proteins like C-reactive ptotein (CRP), soluble intracellular adhesion molecule-1 (sICAM-1), soluble vascular adhesion molecule-1 (sVCAM-1), and progranulin (PGRN). The CRP, sICAM-1, and sVCAM-1 levels were positively correlated with the length of the QT interval. Although the serum PGRN levels were not increased in the SSc group compared to the controls, in SSc patients, the PGRN levels were positively correlated with the QT interval and the AIX. According to our results, we conclude that there may be a potential association between autoimmune inflammation and the risk for ventricular arrhythmias in patients with SSc. We emphasize that the measurement of laboratory parameters of inflammatory activity including CRP, PGRN, sVCAM-1, and sICAM-1 could be helpful in the prediction of sudden cardiac death in patients with SSc.
在系统性硬化症(SSc)中,心肌的纤维化以及持续的自身免疫炎症会改变心肌细胞的电功能,这可能会增加室性心律失常和心脏性猝死的风险。我们分析了 26 例 SSc 患者和 36 例健康对照者的心电图(ECG)变量,这些变量描述了心室复极,如 QT 间期、QT 离散度(QTd)、T 波峰-末间期(Tpe)和心律失常指数(AIX)。此外,还检查了超声心动图和实验室参数,重点关注 C 反应蛋白(CRP)、可溶性细胞间黏附分子-1(sICAM-1)、可溶性血管细胞黏附分子-1(sVCAM-1)和颗粒蛋白前体(PGRN)等炎症蛋白。CRP、sICAM-1 和 sVCAM-1 水平与 QT 间期的长度呈正相关。尽管 SSc 组的血清 PGRN 水平与对照组相比没有升高,但在 SSc 患者中,PGRN 水平与 QT 间期和 AIX 呈正相关。根据我们的结果,我们得出结论,自身免疫炎症与 SSc 患者发生室性心律失常的风险之间可能存在潜在关联。我们强调,测量 CRP、PGRN、sVCAM-1 和 sICAM-1 等炎症活动的实验室参数可能有助于预测 SSc 患者的心脏性猝死。