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纤维肌痛患者额面QRS-T角保持不变:一项对常规心电图筛查有启示意义的横断面研究。

Frontal QRS-T angle remains unchanged in fibromyalgia: a cross-sectional study with implications for routine ECG screening.

作者信息

Tezcan Hüseyin, Tezcan Ezgi Akyıldız

机构信息

Department of Cardiology, Faculty of Medicine, Selcuk University, Konya, Türkiye.

Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Selcuk University, Konya, Türkiye.

出版信息

Front Med (Lausanne). 2025 Jul 8;12:1615561. doi: 10.3389/fmed.2025.1615561. eCollection 2025.

Abstract

AIM

Fibromyalgia syndrome (FMS) is a chronic condition characterized by widespread pain and associated with systemic diseases. Although autonomic dysfunction in FMS may predispose to cardiac arrhythmias, its impact on cardiac parameters, such as the frontal QRS-T [f(QRS-T)] angle, remains unclear. This study aimed to investigate the f(QRS-T) angle in FMS patients compared to healthy controls.

METHODS

A total of 75 FMS patients and 75 healthy controls were included in this cross-sectional study. Disease severity was assessed using the Fibromyalgia Impact Questionnaire (FIQ). The f(QRS-T) angle was calculated from 12-lead electrocardiograms by a blinded cardiologist. Associations between the f(QRS-T) angle, FIQ scores, and duloxetine use were analyzed using appropriate statistical methods.

RESULTS

No significant differences in the f(QRS-T) angle were observed between FMS patients and controls ( = 0.973). Additionally, no correlation was found between FIQ scores and the f(QRS-T) angle ( = 0.725). Subgroup analysis revealed no significant differences in the f(QRS-T) angle between FMS patients using duloxetine and those not using it ( = 0.503).

CONCLUSION

Contrary to concerns about subclinical cardiac involvement in FMS, our findings reveal no significant alterations in the f(QRS-T) angle among FMS patients. Moreover, disease severity and duloxetine use do not influence this parameter. These results challenge the assumption of clinically relevant cardiac dysregulation in FMS and suggest that routine ECG screening may not be necessary for patients with FMS. Nonetheless, longitudinal studies are warranted to fully clarify the long-term cardiac risk in this population.

摘要

目的

纤维肌痛综合征(FMS)是一种以广泛疼痛为特征的慢性疾病,并与全身性疾病相关。尽管FMS中的自主神经功能障碍可能易引发心律失常,但其对心脏参数的影响,如额面QRS-T [f(QRS-T)] 角,仍不明确。本研究旨在调查FMS患者与健康对照者的f(QRS-T)角。

方法

本横断面研究共纳入75例FMS患者和75例健康对照者。使用纤维肌痛影响问卷(FIQ)评估疾病严重程度。由一位不知情的心脏病专家从12导联心电图计算f(QRS-T)角。使用适当的统计方法分析f(QRS-T)角、FIQ评分和度洛西汀使用之间的关联。

结果

FMS患者与对照者之间在f(QRS-T)角上未观察到显著差异( = 0.973)。此外,FIQ评分与f(QRS-T)角之间未发现相关性( = 0.725)。亚组分析显示,使用度洛西汀的FMS患者与未使用度洛西汀的患者在f(QRS-T)角上无显著差异( = 0.503)。

结论

与对FMS患者亚临床心脏受累的担忧相反,我们的研究结果显示FMS患者的f(QRS-T)角无显著改变。此外,疾病严重程度和度洛西汀的使用并不影响该参数。这些结果挑战了FMS中存在临床相关心脏失调的假设,并表明FMS患者可能无需进行常规心电图筛查。尽管如此,仍有必要进行纵向研究以充分阐明该人群的长期心脏风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c839/12279751/cee66ea896ad/fmed-12-1615561-g001.jpg

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