title: Prolonged Tp-e interval and Tp-e/QT correlates well with modified Rodnan skin severity score in patients with systemic sclerosis.
abstract: BACKGROUND
  Ventricular arrhythmias can be seen in systemic sclerosis (SSc) patients and are thought to be a result of fibrosis or ischemia of the ventricular myocardium. Tp-e interval and Tp-e/QT ratio are electrocardiographic (ECG) indices to predict ventricular tachyarrhythmia and cardiovascular mortality. We aimed to evaluate Tp-e interval and Tp-e/QT ratio in patients with SSc.
  
  
  METHODS
  A total of 107 patients with SSc (mean age, 48.6 ± 14.0 years; 96 females) and 100 healthy controls (mean age, 49.4 ± 8.6 years; 90 females) were enrolled. The standard 12-lead ECG was recorded; QTc, Tp-e interval and Tp-e/QT ratio were measured. Modified Rodnan skin severity score (MR-SSS) calculated for all SSc patients.
  
  
  RESULTS
  Tp-e interval (90.7 ± 23.8 ms vs. 84.0 ± 20.6 ms, p = 0.032) and Tp-e/QT ratio (0.20 ± 0.05 vs. 0.18 ± 0.04, p = 0.007, respectively) were significantly prolonged in SSc patients than in the control group. Pearson's correlation analyses revealed positive correlations of MR-SSS with QTc (r = 0.427, p = 0.001), Tp-e interval (r = 0.620, p = 0.001) and Tp-e/ /QT ratio (r = 0.615, p = 0.001). MR-SSS (b = 2.108, p = 0.001) and CRP (b = 2.273, p = 0.027) were found to be significant independent predictors of Tp-e interval. Similarly, MR-SSS (b = 0.004, p = 0.001) was only a significant independent predictor of Tp-e/QT ratio among patients with SSc.
  
  
  CONCLUSIONS
  The patients with SSc had a prolonged Tp-e interval and Tp-e/QT ratio compared with normal subjects. Furthermore, this prolongation was well correlated with clinical severity score among patients with SSc. Ventricular repolarization dispersion as a predictor of ventricular arrhythmias was found to be diminished in patients with SSc. Patients with SSc, particularly with higher MR-SSS, should be followed closely for adverse cardiovascular outcomes.
authors.affiliation: Department of Cardiology, Memorial Ankara Hospital, Ankara, Turkey. sercanokutucu@yahoo.com.
authors.forename: Sercan
authors.initials: S
authors.lastname: Okutucu
authors.forename: Ugur Nadir
authors.initials: UN
authors.lastname: Karakulak
authors.forename: Hakan
authors.initials: H
authors.lastname: Aksoy
authors.forename: Cengiz
authors.initials: C
authors.lastname: Sabanoglu
authors.forename: Vedat
authors.initials: V
authors.lastname: Hekimsoy
authors.forename: Levent
authors.initials: L
authors.lastname: Sahiner
authors.forename: Ergun Baris
authors.initials: EB
authors.lastname: Kaya
authors.forename: Ali
authors.initials: A
authors.lastname: Akdogan
authors.forename: Giray
authors.initials: G
authors.lastname: Kabakci
authors.forename: Kudret
authors.initials: K
authors.lastname: Aytemir
authors.forename: Lale
authors.initials: L
authors.lastname: Tokgozoglu
authors.forename: Ali
authors.initials: A
authors.lastname: Oto
mesh_terms: D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012595:Scleroderma, Systemic / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology
keywords: Tp-e interval; Tp-e/QT ratio; systemic sclerosis