Session Information
Date: Monday, November 9, 2015
Title: Systemic Sclerosis, Fibrosing Syndromes and Raynaud's - Clinical Aspects and Therapeutics Poster II
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: Cardiac involvement is a common subclinical feature of systemic sclerosis (SSc) and results from the widespread fibrosis observed during disease course. Fragmented QRS (fQRS) patterns are seen in myocardial interstitial fibrosis which is also the characteristic feature of SSc. The aim of this study is to evaluate the frequency of fQRS patterns in SSc patients and investigate its association with other clinical findings by using healthy and diseased controls.
Methods: 63 SSc patients who attended our outpatient clinic for their routine controls, who did not have cardiac symptoms and fulfilled 2013 ACR/EULAR classification criteria were enrolled in the study. Standard 12-lead EKG, pulmonary function tests, and echocardiography were performed in all participants. Fragmented QRS was described as the presence of an additional R wave or R or S wave bridging, or the presence of QRS fragmentation on two consecutive derivations. Nailfold capillaroscopy and Rodnan skin scores were assessed by an experienced rheumatologist. Serologic and demographic data were obtained from patient records. We also enrolled 87 RA patients and 100 healthy controls as diseased and healthy controls, respectively.
Results: The frequency of QRS fragmentation was similar between SSc and RA patients (χ²:4.994, p=0.105, df:2), and significantly higher than healthy controls (χ²:4.382, p=0.036, df:1) (Table). Among 12 SSc patients with fQRS (19%), 5 had notched S waves, 5 had notched R waves, and 3 had rSr pattern. SSc patients had significantly higher rates of QT dispersion when compared to RA and healthy controls (p=0.006). Both SSc and RA patients had significantly higher P dispersion durations than healthy controls (p<0.0001). In univariate analysis, SSc patients with fQRS had longer disease duration, higher Rodnan skin scores, and pulmonary artery pressures, lower forced vital capacity and diffusion capacity, and higher rates of abnormal nailfold capillary patterns. In multivariate analysis, none of these parameters predicted the presence of fQRS.
Conclusion: The frequency of fQRS patterns was higher in our SSc and RA patients. However, this increase in fQRS frequency did not correlate with more severe disease involvement. Longitudinal studies are required to determine whether these fQRS patterns predict early myocardial fibrosis in SSc.
Table.
|
|
SSc (n=63) |
RA (n=87) |
Healthy Controls (n=100) |
P value |
|
Age (years±SD) |
47.3 ± 12.01 |
52.6 ± 13.1 |
45.97 ± 10.39 |
<0.0001 |
|
Disease duration (years) |
8.22 ± 7.96 |
9.90 ±10.01 |
|
0.272 |
|
fQRS |
19.0% (12/63) |
11.49% (10/87) |
8% (8/100) |
0.105 |
|
QT dispersion |
0.035 ± 0.015 |
0.029 ± 0.016 |
0.028 ± 0.011 |
0.006 |
|
P dispersion |
0.024 ± 0.011 |
0.024 ± 0.016 |
0.017 ± 0.009 |
<0.0001 |
To cite this abstract in AMA style:
Uzunaslan D, Saygin C, Kostek M, Ozdemir M, Torun T, Altay S, Hatemi G. Fragmented Qrs Patterns Do Not Correlate with the Degree of Lung and Skin Involvement in Patients with Systemic Sclerosis [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/fragmented-qrs-patterns-do-not-correlate-with-the-degree-of-lung-and-skin-involvement-in-patients-with-systemic-sclerosis/. Accessed .ACR Meeting Abstracts - https://acrabstracts.org/abstract/fragmented-qrs-patterns-do-not-correlate-with-the-degree-of-lung-and-skin-involvement-in-patients-with-systemic-sclerosis/