BackgroundPatients with systemic lupus erythematosus (SLE) have increased cardiovascular morbidity and mortality. Although autopsy studies have documented that the heart is affected in most SLE patients, clinical manifestations occur in less than 10%. QT dispersion is a new parameter that can be used to assess homogeneity of cardiac repolarization and autonomic function. We compared the increase in QT dispersion in SLE patients with high disease activity and mild or moderate disease activity.Methods and ResultsOne hundred twenty-four patients with SLE were enrolled in the study. Complete history and physical exam, ECG, echocardiography, exercise test and SLE disease activity index (SLEDAI) were recorded. Twenty patients were excluded on the basis of our exclusion criteria. The patients were divided to two groups based on SLEDAI: 54 in the high-score group (SLEDAI > 10) and 50 in the low-score group (SLEDAI < 10).QT dispersion was significantly higher in high-score group (58.31 ± 18.66 vs. 47.90 ± 17.41 respectively; P < 0.004). QT dispersion was not significantly higher in patients who had received hydroxychloroquine (54.17 ± 19.36 vs. 50.82 ± 15.96, P = 0.45) or corticosteroids (53.58 ± 19.16 vs. 50.40 + 11.59, P = 0.47). There was a statistically significant correlation between abnormal echocardiographic findings (abnormalities of pericardial effusion, pericarditis, pulmonary hypertension and Libman-Sacks endocarditis) and SLEADI (P < 0.004).ConclusionsQT dispersion can be a useful, simple noninvasive method for the early detection of cardiac involvement in SLE patients with active disease. Concerning high chance of cardiac involvement, cardiovascular evaluation for every SLE patient with a SLEDAI higher than 10 may be recommended.Trial registrationClinicaltrial.gov registration NCT01031797

It seems that in patients with CP, the presence of pericardial calcification and the increasing disease duration are associated with a higher chance of developing AF.

It has previously been shown that maximum P-wave duration and P-wave dispersion in 12-lead surface electrocardiogram (ECG) are significantly increased in patients prone to developing atrial fibrillation. Because patients with mitral stenosis (MS) are also susceptible to developing atrial fibrillation, the present study was carried out to determine whether maximum P-wave duration and P-wave dispersion are prolonged in MS patients during normal sinus rhythm. In addition, the correlation between these P-wave variables and the left atrial size, transmitral valve gradient and mitral valve area were determined. Fifty consecutive patients (40 women and 10 men; mean age 35.76±6.59 years) with MS who were in normal sinus rhythm, and a control group of 50 age-and sex-matched healthy persons were studied. A 12-lead ECG was obtained for each subject. All ECGs were scanned through a Cannon scanner at 300 dpi and saved as images in a personal computer. The minimum and maximum P-wave durations, as well as P-wave dispersion, were subsequently calculated. In addition, all patients were evaluated by echocardiography to measure the left atrial size, transmitral valve gradient and mitral valve area by planimetry. The P-wave parameters were compared between the two groups and the correlation between these parameters and the echocardiographic variables were determined in patients with MS. The most important findings included a significant prolongation of maximum P-wave duration in patients with MS compared with controls (P<0.001), and a strong correlation between the maximum P-wave duration and left atrial size (r=0.505, P<0.001), transmitral valve gradient (r=0.371, P=0.01) and a significant negative correlation with mitral valve area (r=-0.379, P=0.007). There was no correlation between the P-wave dispersion and echocardiographic parameters.Key Words: Maximum P-wave duration; Minimum P-wave duration; P-wave dispersion; Rheumatic mitral stenosis P -wave prolongation has been used as a marker of interatrial conduction disturbance and prolonged atrial conduction time, which has been associated with a high frequency of atrial fibrillation (AF). These atrial conduction disturbances are nonuniform and site dependent, and may result in a highly variable P-wave duration in the different leads of a 12-lead electrocardiogram (ECG). As a marker of this variation, the Pwave dispersion has been introduced as the difference between the maximum and minimum P-wave duration. Prolonged Pwave duration and P-wave dispersion have been found to be predictive of later AF in patients with idiopathic AF (1-4), and recurrence of AF following cardioversion (5,6).Because patients with rheumatic mitral stenosis (MS) are prone to develop AF, the present study was designed to find out whether the maximum P-wave duration and P-wave dispersion are prolonged in these patients, and to find out if these variables have any correlation with the left atrial size, transmitral valve gradient or mitral valve area as an index of the severity of valvular stenosis. METHODS Pa...

Background:Oncologists today are greatly concerned about the treatment of relapsed/refractory acute leukemia. FLANG regimen, combination of novantron, cytarabine, fludarabine, and granulocyte-colony stimulating factor, has been used in treatment of refractory/relapsed acute leukemia since 1990s. The present study has evaluated mortality and response rate of this regimen.Materials and Methods:In this study, 25 patients with refractory/relapsed acute leukemia aged 15-55 years underwent FLANG regimen at Seyed-Al-Shohada Hospital, Isfahan, Iran during 2008-2009. One month later, bone marrow samples were taken to evaluate the responsiveness to treatment. Participants were followed for a year. The data was analyzed by student-t and chi-square tests, logistic, and Cox regression analysis, and Kaplan-Meier curves in SPSS19.Results:Out of the 25 patients, 8 patients (32%) had acute lymphoblastic leukemia (5 refractory and 3 relapsed cases) and 17 subjects had acute myeloid leukemia (7 refractory and 10 relapsed cases). According to the bone marrow biopsies taken one month after FLANG regimen, 10 patients (40%) had responded to treatment. Five patients of the 10 responders underwent successful bone marrow transplantation (BMT). On the other hand, 13 patients (52%), who had not entered the CR period, died during the follow-up. Logistic regression analysis did not reveal any significant associations between disease type and responsiveness to treatment.Conclusion:This study indicated higher rates of unresponsiveness to treatment while its mortality rate was comparable with other studies. Overall, according to limitations for BMT (as the only chance for cure) in Iran, it seems that FLANG therapy is an acceptable choice for these patients.