Abstract
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.
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Mandell BF (1987) Cardiovascular involvement in systemic lupus erythematosus. Semin Arthritis Rheum 17:126–141
Hejtmancik MR, Wright JC, Quint R, Jennings FL (1964) The cardiovascular manifestations of systemic lupus erythematosus. Am Heart J 68:119–130
Kautzner J, Malik M (1997) QT interval dispersion and its clinical utility. PACE 20:2625–2640
Zabel M, Portnoy S, Franz MR (1995) Electrocardiographic indexes of dispersion of ventricular repolarization: an isolated heart validation study. J Am Coll Cardiol 25:746
Yildirir A, Aksoyek S, Calguneri M et al (2000) QT dispersion as a predictor of arrhythmic events in patients with ankylosing spondylitis. Rheumatology (Oxford) 39(8):875–879
Pırıldar T, Sekuri C, Utuk O, Kemal Tezcan U (2003) QT dispersion in rheumatoid arthritis patients with and without Sjögren’s syndrome. Clin Rheumatol 22:225–228
Cindas A, Gokce-Kutsal Y, Tokgozoglu L, Karanfil A (2002) QT dispersion and cardiac involvement in patients with rheumatoid arthritis. Scand J Rheumatol 31(1):22–26
Tan EM, Cohen AS, Fries JF et al (1982) The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 25:1271–1277
Gladman DD, Ibanez D, Urowitz MB (2002) Systemic lupus erythematosus disease activity index 2000. J Rheumatol 29(2):288–291
Marek M, Camm AJ (1997) Mystery of QTc interval dispersion. Am J Cardiol 79:785–787
Zabel M, Woosly RL, Franz MR (1997) Is dispersion of ventricular repolarisation rate dependent? PACE 20(Part I):2405–2411
Perkiomaki JS, Koistien J, Yli-Mary S, Huikuri HV (1995) Dispersion of QT interval in patients with and without susceptibility to ventricular tachyarhythmias after previous myocardial infarction. J Am Coll Cardiol 26:174–179
Statters DJ, Malik M,Ward DE, Camm AJ (1994) QT dispersion: problems of methodology and clinical significance. J Cardiovasc Electrophysiol 5:672–685
Glancy JM, Garratt CJ, Woods KI, de Bono DP (1995) QT dispersion and mortality after myocardial infarction. Lancet 345:945–948
Tieleman RG, Crijns HJ, Wiesfeld AC, Posma J, Hamer HM, Lie KI (1995) Increased dispersion of recractoriness in the absence of QT prolongation in patients with mitral valve prolapse and ventricular arrhythmias. Br Heart J 73:37–40
Barr CS, Naas A, Freeman M, Lang CC, Struthers AD (1994) QT dispersion and sudden unexpected death in chronic heart failure. Lancet 343:327–329
Sgreccia A, Morelli S, Ferrante L et al (1998) QT interval and QT dispersion in systemic sclerosis (scleroderma). J Int Med 243:127–132
Schillaci O, Lagana B, Danieli R et al (1999) Technetium-99 m sestamibi single-photon emission tomography detects subclinical myocardial perfusion abnormalities in patients with systemic lupus erythematosus. Eur J Nucl Med 26(7):713–717
Lin CC, Ding HJ, Chen YW, Wang JJ, Ho ST, Kao A (2003) Usefulness of technetium-99 m sestamibi myocardial perfusion SPECT in detection of cardiovascular involvement in patients with systemic lupus erythematosus or systemic sclerosis. Int J Cardiol 92:157–161
Sun SS, Shiau YC, Tsai SC, Lin CC, Kao A, Lee CC (2001) The role of technetium-99 m sestamibi myocardial perfusion single-photon emission computed tomography (SPECT) in the detection of cardiovascular involvement in systemic lupus erythematosus patients with non-specific chest complaints. Rheumatology 40:1106–1111
Lagana B, Tubani L, Maffeo N et al (1996) Heart rate variability and cardiac autonomic function in systemic lupus erythematosus. Lupus 1:49–55
Wei K, Dorian P, Newman D, Langer A (1995) Association between QT dispersion and autonomic dysfunction in patients with diabetes mellitus. J Am Coll Cardiol 26:859–863
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Yavuz, B., Atalar, E., Karadag, O. et al. QT dispersion increases in patients with systemic lupus erythematosus. Clin Rheumatol 26, 376–379 (2007). https://doi.org/10.1007/s10067-006-0364-5
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DOI: https://doi.org/10.1007/s10067-006-0364-5