title: The importance of fragmented QRS in the early detection of cardiac involvement in patients with systemic sclerosis.
abstract: OBJECTIVE
  Systemic sclerosis (SSc) is an autoimmune connective tissue disorder characterized by fibrosis. The prognosis of the disease is bad when clinically symptomatic cardiac dysfunction is occurred, therefore early detection of cardiac dysfunction is important in patients with SSc. The aim of this study was to investigate the frequency of fQRS in superficial electrocardiography in cardiacally asymptomatic patients with SSc and its relation to the systolic pulmonary artery pressure (sPAP).
  
  
  METHODS
  This study included 31 cardiacally asymptomatic patients with SSc (23 females, 40.4±9.2 years) and 41 healthy volunteers as the control (31 females, 38.2±11.8 years). The ECGs with 12 derivations and transthoracic echocardiographies of the patients were evaluated. The presence of fQRS in the superficial ECG, and its relation to systolic pulmonary artery pressure (sPAP) were investigated.
  
  
  RESULTS
  The mean sPAP value in the SSc group was observed to be higher than that of the control group (26 mm Hg and 20 mm Hg, respectively, p<0.001). The presence of fQRS in the SSc group was more frequent than the control group (55% and 10%, respectively, p<0.001). In SSc patients presence of fQRS become relevant with ≥24 mm Hg sPAP by 88% sensitivity and 79% specificity.
  
  
  CONCLUSIONS
  In our study, the presence of fQRS in SSc patients, were more frequent than in the normal population. Since pulmonary hypertension is the primary cause of mortality in patients with SSc, the correlation of fQRS with sPAP should also be considered.
authors.affiliation: Clinic of Cardiology, Antalya Training and Research Hospital; Antalya-Turkey. dr.nermin@mynet.com.
authors.forename: Nermin
authors.initials: N
authors.lastname: Bayar
authors.forename: Hasan Fatih
authors.initials: HF
authors.lastname: Çay
authors.forename: Zehra
authors.initials: Z
authors.lastname: Erkal
authors.forename: İlhan
authors.initials: İ
authors.lastname: Sezer
authors.forename: Şakir
authors.initials: Ş
authors.lastname: Arslan
authors.forename: Göksel
authors.initials: G
authors.lastname: Çağırcı
authors.forename: Serkan
authors.initials: S
authors.lastname: Çay
authors.forename: İsa Öner
authors.initials: İÖ
authors.lastname: Yüksel
authors.forename: Erkan
authors.initials: E
authors.lastname: Köklü
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000175:diagnosis*; D009202:Cardiomyopathies / Q000150:complications / Q000175:diagnosis*; D016022:Case-Control Studies; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D012595:Scleroderma, Systemic / Q000150:complications*