QT Interval Prolongation in Patients with Systemic Sclerosis—Are the Holter ECG Recordings a Better Option for QT Interval Evaluation?

Saramet, Elena E.; Cojocaru, Doina-Clementina; Ungurianu, Sorin; Negru, Robert D.; Ancuta, C.

doi:10.3390/medicina57030295

Cited by 4 publications

(5 citation statements)

References 19 publications

(6 reference statements)

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“…These results are similar to other studies [9,20,24] confirming the link between inflammatory process and QTc interval prolongation. Only the number of the sinusal QRS with QTc > 450 ms recorded during 24 h monitoring was significantly correlated with the number of premature ventricular contractions (PVC), a correlation confirmed also in patients with systemic sclerosis [29]. In our study, the percentage of RA patients (54%) with ventricular arrhythmic events was similar to the results of previous studies that used 24 h Holter monitoring, studies which were not able to identify any significant differences between patients with RA and controls with respect to these events [30,31].…”

Section: Discussionmentioning

confidence: 70%

24 h Holter ECG Monitoring of Patients with Rheumatoid Arthritis—A Potential Role for a Precise Evaluation of QT Interval Duration and Associated Arrhythmic Complications

et al. 2022

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Background: Patients with rheumatoid arthritis (RA) have increased systemic inflammatory burden associated with elevated cardiovascular mortality. Prolonged ventricular repolarisation evaluated by QT interval duration is a risk factor for cardiovascular and total mortality. In RA, mortality risk is correlated with dynamics and cumulative incidence of QTc prolongation rather than QTc value. The aim is to evaluate if QT parameters evaluated with 24 h Holter ECG are a better option to complete the cardiovascular profile of RA patients than parameters from short ECG recordings. Materials and methods: A total of 58 patients (22 males, 36 females) with RA were submitted to short ECG recordings at admission and to 24 h Holter ECG. QT interval parameters and ventricular ectopy generated from both types of recordings were analyzed. Results: QTc interval values obtained from Holter ECG were significantly higher than the values from short term ECG and were correlated with severity of inflammatory process. The number of QRS complexes with QTc > 450 ms recorded during 24 h Holter was strongly correlated with the number of ventricular events and severity of the inflammatory process. Conclusions: In patients with RA, the Holter ECG recordings could realize a more precise evaluation of the extent and dynamics of QTc interval duration and of ventricular ectopic events with potential risk of sudden death.

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Section: Discussionmentioning

confidence: 70%

24 h Holter ECG Monitoring of Patients with Rheumatoid Arthritis—A Potential Role for a Precise Evaluation of QT Interval Duration and Associated Arrhythmic Complications

et al. 2022

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“…If any conflicts emerged during the review process, they were resolved by discussion among the readers. Sixty articles were finally included in this systematic literature review [ 8 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 ...…”

Section: Resultsmentioning

confidence: 99%

“…Prevalence of premature ventricular contractions (PVC) ranged from 3.7% (1/27) to 100% (39/39) in a SSc cohort with prolonged QT, for which the number of PVC on the Holter EKG was significantly higher ( p = 0.04) in patients with dcSSc compared to lcSSc [ 15 , 59 ]. Of the studies that reported mean PVC, this value varied between 197 ± 527 and 2046.1 ± 6027.8 [ 21 , 57 ].…”

Section: Resultsmentioning

confidence: 99%

Arrhythmias and Conduction Disturbances in Patients with Systemic Sclerosis—A Systematic Literature Review

Vrâncianu

Gheorghiu

Popa³

et al. 2022

IJMS

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Systemic sclerosis (SSc) is an autoimmune disease characterized by skin and internal organ fibrosis and microvascular impairment, which can affect major organs, including the heart. Arrhythmias are responsible for approximately 6% of deaths in patients with SSc, and mainly occur due to myocardial fibrosis, which causes electrical inhomogeneity. The aim of this study was to determine the frequency of arrhythmias and conduction disturbances in SSc cohorts, and to identify the characteristics and risk factors associated with the occurrence of dysrhythmias in patients with SSc. A systematic literature review using PubMed, Embase, Web of Science and Scopus databases was performed. Full-text articles in English with arrhythmias as the main topic published until 21 April 2022 were included. Most prevalent arrhythmias were premature supraventricular and ventricular contractions, while the most frequent conduction disturbance was represented by right bundle branch block (RBBB). Elevated concentrations of N-terminal prohormones of brain natriuretic peptides (NT-pro BNP) were associated with numerous types of atrial and ventricular arrhythmias, and with the occurrence of RBBB. A lower value of the turbulence slope (TS) emerged as an independent predictor for ventricular arrhythmias. In conclusion, dysrhythmias are frequent in SSc cohorts. Paraclinical and laboratory parameters are useful instruments that could lead to early diagnosis in the course of the disease.

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“…The most frequent ECG abnormalities in SSc patients are represented by P wave abnormalities, non-specific abnormalities of ST-segment and T wave, QRS micro voltage, and more subtle changes like the low values of the heart rate variability parameters, QT dispersion (QTd) increase. 9 The prolongation of QTc interval has been also observed in patients with SSc without cardiac manifestations and in the absence of echocardiographic abnormalities which can lead to life threatening tachyarrhythmias. 10 …”

Section: Introductionmentioning

confidence: 99%

QTc is Prolonged in Patients with SSc and Associates with Skin Score

Fatemi

Abdolahi

Aghaei

et al. 2023

MJR

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Background: Systemic sclerosis is an autoimmune disease characterised by endothelial dysfunction and fibrosis of the skin and internal organs. Cardiac involvement during systemic sclerosis can be primary or secondary to pulmonary arterial hypertension and renal pathology. Among the disorders in systemic sclerosis, prolongation of QTc time is also associated with more anti-RNA polymerase III antibodies, longer duration, and severity of disease. Methods: This case-control study was performed on 35 patients with systemic scleroderma who filled in the American Society of Rheumatism (ACR / EULAR criteria) and 35 healthy subjects prior to entering the study. Then, the QTc distance was extracted from the electrocardiogram and calculated using the formula. The measured QTc distance in the electrocardiogram, QTc> 440ms in men and QTc> 460ms in women, was defined as QTc long. The patients and the control group then underwent echocardiography, and changes in QTc interval and their relations with echocardiographic findings were evaluated. Results: The results of this study indicated a significant relationship between QTc distance in patients with scleroderma compared with healthy controls. There was also a significant relationship between QTc and Skin Score of patients. However, there was no significant correlation between QTc distance and age, duration of disease, Anti-Centromere, Anti-Scl70, and pulmonary artery pressure. Conclusion: This study concludes that patients with scleroderma are at high risk for cardiac conduction impairment. The only factor that significantly correlated with QTc was the Skin Score of the patients.

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QT Interval Prolongation in Patients with Systemic Sclerosis—Are the Holter ECG Recordings a Better Option for QT Interval Evaluation?

Cited by 4 publications

References 19 publications

24 h Holter ECG Monitoring of Patients with Rheumatoid Arthritis—A Potential Role for a Precise Evaluation of QT Interval Duration and Associated Arrhythmic Complications

24 h Holter ECG Monitoring of Patients with Rheumatoid Arthritis—A Potential Role for a Precise Evaluation of QT Interval Duration and Associated Arrhythmic Complications

Arrhythmias and Conduction Disturbances in Patients with Systemic Sclerosis—A Systematic Literature Review

QTc is Prolonged in Patients with SSc and Associates with Skin Score

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