Electrocardiography in 110 patients with systemic sclerosis: a cross-sectional comparison with population-based controls

Nordin, Annika; Björnådal, Lena; Larsson, Anders; Svenungsson, Elisabet; Jensen‐Urstad, Kerstin

doi:10.3109/03009742.2013.843720

Cited by 27 publications

(17 citation statements)

References 149 publications

(167 reference statements)

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“…Nordin et al assessed conduction abnormalities, septal Q-wave patterns, ST-T wave abnormalities, QTc duration, premature contractions and heart rate variability between SSc subsets and found no significant differences, although this was a small study with 110 patients of which only 22% was diagnosed with diffuse SSc [30]. In the current study no relevant differences were detected in heart rate, QRS and QTc duration between the subgroups.…”

Section: Discussioncontrasting

confidence: 76%

Electrocardiographic detection of pulmonary hypertension in patients with systemic sclerosis using the ventricular gradient

Couperus

Vliegen

Henkens

et al. 2016

Journal of Electrocardiology

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Section: Discussioncontrasting

confidence: 76%

Electrocardiographic detection of pulmonary hypertension in patients with systemic sclerosis using the ventricular gradient

Couperus

Vliegen

Henkens

et al. 2016

Journal of Electrocardiology

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“…In a study, the frequencies of ECG abnormalities such as QT prolongation and ventricular extrasystole were higher in patients with SSc. 27 Sgreccia et al 7 found that QT dispersion and QT interval were increased significantly in patients with SSc. Also, Gialafos et al 28 demonstrated that abnormal spatial QRS-T angle, a marker of ventricular repolarization, was wider in patients with SSc.…”

Section: Discussionmentioning

confidence: 97%

The Assessment of Tp-e Interval and Tp-e/QT Ratio in Patients With Systemic Sclerosis

Yayla

et al. 2016

Arch Rheumatol

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Objectives: This study aims to investigate ventricular repolarization using T-peak to T-end (Tp-e) intervals and Tp-e/QT ratios in patients with systemic sclerosis (SSc). Patients and methods: Totally 65 patients (8 males, 57 females; mean age 49.8 years; range 20 to 77 years) with SSc and 63 control subjects (8 males, 55 females; mean age 49.3 years; range 20 to 77 years) were enrolled. Tp-e intervals, Tp-e/QT, and Tp-e/corrected QT (QTc) ratios were measured from the 12-lead electrocardiogram. Results: Tp-e intervals, QT intervals, QTc intervals, Tp-e/QT, and Tp-e/QTc ratios were significantly higher in patients with SSc than control subjects (all p<0.01). There was no difference between patients with diffuse and limited cutaneous SSc in terms of electrocardiogram and echocardiographic findings. Correlation analysis revealed no correlation between Tp-e intervals, Tp-e/QT, and Tp-e/QTc ratios with disease duration and anti-Sjögren's syndrome antigen A antibody levels in patients with SSc (all p>0.05). Conclusion: Our study showed that Tp-e intervals, Tp-e/QT, and Tp-e/QTc ratios were increased in patients with SSc than control subjects. The increased frequency of ventricular arrhythmias can be clarified by increased indexes of ventricular repolarization parameters in patients with SSc.

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“…SSc affects ∼2.5 million patients worldwide with 300 000 new cases being diagnosed per year [ 2 ], and studies place cardiac-related mortality between 26 and 36% [ 3 , 4 ]. Rhythm disturbances account for the majority of cardiac death, and cardiac involvement conveys a poorer prognosis in SSc [ 3 , 5 ], with the 24 h Holter recording constituting the mainstay of initial cardiac evaluation [ 6 ]. The incidence of sudden cardiac death (SCD) in SSc may be underestimated in the literature [ 7 ], as it has not been recently evaluated by large studies and the causes of death in SSc have changed over the years in response to newer therapeutic approaches [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Cardiac magnetic resonance predicts ventricular arrhythmias in scleroderma: the Scleroderma Arrhythmia Clinical Utility Study (SAnCtUS)

et al. 2019

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Objectives Cardiac rhythm disturbances constitute the most frequent cardiovascular cause of death in SSc. However, electrocardiographic findings are not a part of risk stratification in SSc. We aimed to translate 24 h Holter findings into a tangible risk prediction score using cardiovascular magnetic resonance. Methods The Scleroderma Arrhythmia Clinical Utility Study (SAnCtUS) was a prospective multicentre study including 150 consecutive SSc patients from eight European centres, assessed with 24 h Holter and cardiovascular magnetic resonance, including ventricular function, oedema (T2 ratio) and late gadolinium enhancement (%LGE). Laboratory/clinical parameters were included in multivariable corrections. A combined endpoint of sustained ventricular tachycardia requiring hospitalization and sudden cardiac death at a median (interquartile range) follow-up of 1 (1.0–1.4) year was generated. Results Only T2 ratio and %LGE were significant predictors of ventricular rhythm disturbances, but not of supraventricular rhythm disturbances, after multivariable correction and adjustment for multiple comparisons. Using decision-tree analysis, we created the SAnCtUS score, a four-category scoring system based on T2 ratio and %LGE, for identifying SSc patients at high risk of experiencing ventricular rhythm disturbance at baseline. Increasing SAnCtUS scores were associated with a greater disease and arrhythmic burden. All cases of non-sustained ventricular tachycardia (n = 7) occurred in patients with the highest SAnCtUS score (=4). Having a score of 4 conveyed a higher risk of reaching the combined endpoint in multivariable Cox regression compared with scores 1/2/3 [hazard ratio (95% CI): 3.86 (1.14, 13.04), P = 0.029] independently of left ventricular ejection fraction and baseline ventricular tachycardia occurrence. Conclusion T2 ratio and %LGE had the greatest utility as independent predictors of rhythm disturbances in SSc patients.

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Electrocardiography in 110 patients with systemic sclerosis: a cross-sectional comparison with population-based controls

Cited by 27 publications

References 149 publications

Electrocardiographic detection of pulmonary hypertension in patients with systemic sclerosis using the ventricular gradient

Electrocardiographic detection of pulmonary hypertension in patients with systemic sclerosis using the ventricular gradient

The Assessment of Tp-e Interval and Tp-e/QT Ratio in Patients With Systemic Sclerosis

Cardiac magnetic resonance predicts ventricular arrhythmias in scleroderma: the Scleroderma Arrhythmia Clinical Utility Study (SAnCtUS)

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