Cardiac repolarization abnormalities and increased sympathetic activity in scleroderma.
BACKGROUND
Cardiac involvement in scleroderma is a poor prognostic sign and is usually underdiagnosed, particularly in asymptomatic patient. This paper focuses on QT dynamicity and heart rate variability (HRV) in patients with scleroderma and controls in an attempt to investigate the cardiac autonomic system and ventricular repolarization.


METHODS
Sixty patients with scleroderma and 30 age- and sex-matched healthy controls who had no cardiovascular risk factors were included in this study. All patients and the controls underwent a 24-hour holter recording as well as a transthoracic echocardiography. HRV and QT dynamicity parameters were calculated.


RESULTS
In HRV analysis, autonomic balance was changed in favor of the sympathetic system in patients with diffuse scleroderma. In QT dynamicity analysis, QT/RR slopes were significantly steeper in patients with diffuse scleroderma compared to patients with limited scleroderma and controls (QTapex/RR: 0.24 +/- 0.16, 0.15 +/- 0.03, 0.14 +/- 0.03 respectively p < 0.001; QTend/RR: 0.26 +/- 0.17, 0.14 +/- 0.04, 0.13 +/- 0.05, respectively p < 0.001).


CONCLUSIONS
Patients with diffuse scleroderma may have asymptomatic cardiac repolarization abnormalities and autonomic dysfunction. Our results may indicate that QT dynamicity and HRV can be useful noninvasive methods that may detect impaired state of autonomic balance and cardiac repolarization in patients with diffuse scleroderma.
Ciftci
Orcun
O
Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Onat
Ahmet Mesut
AM
Yavuz
Bunyamin
B
Akdogan
Ali
A
Aytemir
Kudret
K
Tokgozoglu
Lale
L
Sahiner
Levent
L
Deniz
Ali
A
Ureten
Kemal
K
Kizilca
Guler
G
Calguneri
Meral
M
Oto
Ali
A
D001145:Arrhythmias, Cardiac / Q000209:etiology*; D016022:Case-Control Studies; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012595:Scleroderma, Systemic / Q000150:complications* / Q000503:physiopathology; D013564:Sympathetic Nervous System / Q000503:physiopathology*