title: QT dispersion in patients with systemic lupus erythematosus: the impact of disease activity.
abstract: BACKGROUND
  Patients with systemic lupus erythematosus (SLE) have increased cardiovascular morbidity and mortality. Although autopsy studies have documented that the heart is affected in most SLE patients, clinical manifestations occur in less than 10%. QT dispersion is a new parameter that can be used to assess homogeneity of cardiac repolarization and autonomic function. We compared the increase in QT dispersion in SLE patients with high disease activity and mild or moderate disease activity.
  
  
  RESULTS
  One hundred twenty-four patients with SLE were enrolled in the study. Complete history and physical exam, ECG, echocardiography, exercise test and SLE disease activity index (SLEDAI) were recorded. Twenty patients were excluded on the basis of our exclusion criteria. The patients were divided to two groups based on SLEDAI: 54 in the high-score group (SLEDAI > 10) and 50 in the low-score group (SLEDAI < 10).QT dispersion was significantly higher in high-score group (58.31 ± 18.66 vs. 47.90 ± 17.41 respectively; P < 0.004). QT dispersion was not significantly higher in patients who had received hydroxychloroquine (54.17 ± 19.36 vs. 50.82 ± 15.96, P = 0.45) or corticosteroids (53.58 ± 19.16 vs. 50.40 + 11.59, P = 0.47). There was a statistically significant correlation between abnormal echocardiographic findings (abnormalities of pericardial effusion, pericarditis, pulmonary hypertension and Libman-Sacks endocarditis) and SLEADI (P < 0.004).
  
  
  CONCLUSIONS
  QT dispersion can be a useful, simple noninvasive method for the early detection of cardiac involvement in SLE patients with active disease. Concerning high chance of cardiac involvement, cardiovascular evaluation for every SLE patient with a SLEDAI higher than 10 may be recommended.
  
  
  BACKGROUND
  Clinicaltrial.gov registration NCT01031797.
authors.affiliation: Cardiology Department, Shiraz University of Medical Sciences, Iran. kojurij@yahoo.com
authors.forename: Javad
authors.initials: J
authors.lastname: Kojuri
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Nazarinia
authors.forename: Mohammad
authors.initials: M
authors.lastname: Ghahartars
authors.forename: Yadollah
authors.initials: Y
authors.lastname: Mahmoody
authors.forename: Gholam reza
authors.initials: Gr
authors.lastname: Rezaian
authors.forename: Lida
authors.initials: L
authors.lastname: Liaghat
mesh_terms: D000305:Adrenal Cortex Hormones / Q000494:pharmacology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006331:Heart Diseases / Q000150:complications / Q000209:etiology; D006801:Humans; D006886:Hydroxychloroquine / Q000494:pharmacology; D006973:Hypertension / Q000150:complications; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D006886:Hydroxychloroquine