title: Electrocardiographic evaluation in patients with systemic scleroderma and without clinically evident heart disease.
abstract: BACKGROUND
  In patients with systemic scleroderma (SSc), clinically evident cardiac involvement is recognized to be a poor prognostic factor. The aim of the study was to evaluate electrocardiographic changes, parameters of heart rate variability (HRV), and heart rate turbulence (HRT) in patients with SSc without evident symptoms of heart disease.
  
  
  METHODS
  A group of 27 patients with SSc were subjected to standard electrocardiography (ECG) examination and 24-hour Holter monitoring. Analysis of HRV in time and frequency domains, HRT, and echocardiography were also performed.
  
  
  RESULTS
  Holter monitoring revealed a larger number of premature supraventricular contractions (PSVCs), as well as premature ventricular contractions (PVCs) in the patients with systemic scleroderma, as compared with the control group. Moreover, the SSc patients showed decreased parameters of time and frequency domains, as referred to the controls, especially during night hours. In four patients, abnormal HRT values were present. On echocardiography, only slight changes were found, however in five patients left ventricle diastolic dysfunction was diagnosed.
  
  
  CONCLUSIONS
  The noninvasive electrocardiographic methods seems to be useful for detecting early heart involvement in course of SSc and could be recommended for routine used in clinical practice. Significance of HRT analysis in patients with SSc needs further elucidation.
authors.affiliation: Department of Pathophysiology, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Biełous-Wilk
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Poreba
authors.forename: Edyta
authors.initials: E
authors.lastname: Staniszewska-Marszałek
authors.forename: Rafał
authors.initials: R
authors.lastname: Poreba
authors.forename: Maciej
authors.initials: M
authors.lastname: Podgórski
authors.forename: Dariusz
authors.initials: D
authors.lastname: Kałka
authors.forename: Dariusz
authors.initials: D
authors.lastname: Jagielski
authors.forename: Lesław
authors.initials: L
authors.lastname: Rusiecki
authors.forename: Witold
authors.initials: W
authors.lastname: Pilecki
authors.forename: Eugeniusz
authors.initials: E
authors.lastname: Baran
authors.forename: Ryszard
authors.initials: R
authors.lastname: Andrzejak
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Sobieszczańska
mesh_terms: D016022:Case-Control Studies; D003971:Diastole; D004452:Echocardiography; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012595:Scleroderma, Systemic / Q000150:complications* / Q000503:physiopathology*; D018709:Statistics, Nonparametric; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000503:physiopathology*; D018879:Ventricular Premature Complexes / Q000209:etiology / Q000503:physiopathology*