title: Prolonged Tpeak-Tend interval in anti-Ro52 antibody-positive connective tissue diseases.
abstract: Patients with connective tissue diseases (CTDs) may have prolonged corrected QT interval which indicates increased risk for ventricular arrhythmias. However, a more sensitive measure of ventricular repolarization, T-peak-to-end (Tpe) interval, has not been studied in CTDs. We aimed to investigate the relationship between ventricular repolarization abnormalities and anti-Ro52-positivity in subjects with connective tissue diseases (CTDs). We enrolled patients with anti-Ro52-positive CTDs, ANA-positive CTDs, and healthy subjects in this cross-sectional study. We excluded conditions potentially affecting the QT interval. We compared the ECG measures between the groups and performed analyses to define factors associated with ventricular repolarization measures. 15 ANA and anti-Ro52-positive, 39 ANA-positive and anti-Ro52-negative, and 22 healthy subjects were enrolled. None of the subjects had rhythm or conduction disturbances. Corrected QT intervals were similar between the groups. Tpe (84, 77.3, and 69.4 msn, respectively) and QT-dispersion (40, 27.2, and 20.1 msn, respectively) were higher in anti-Ro52-positive subjects compared with the ANA-positive and healthy subjects. Anti-Ro52 titers were correlated with Tpe and QT-dispersion (r = 0.52 and p < 0.001 for each). ANA and anti-Ro52-positivity were independently associated with higher Tpe (OR = 7.7, p = 0.001 and OR = 6.9, p = 0.001, respectively), corrected Tpe (OR = 11.3, p = 0.001 and OR = 8.4, p = 0.003, respectively), QT dispersion (OR = 7, p = 0.008 and OR = 13, p < 0.001, respectively), and QTc dispersion (OR = 9.1, p = 0.001 and OR = 14.1, p < 0.001, respectively). This study provides evidence that ANA positivity, especially when concomitant anti-Ro52-positivity is present, significantly deteriorates ventricular repolarization. The aforementioned ventricular repolarization abnormalities may render these subjects susceptible to serious rhythm or conduction disorders in the setting of predisposing conditions.
authors.affiliation: Department of Rheumatology, Uludag University School of Medicine, Gorukle, Bursa, Turkey. draysenurtufan@gmail.com.
authors.forename: Ayse Nur
authors.initials: AN
authors.lastname: Tufan
authors.affiliation: Department of Cardiology, Uludag University School of Medicine, Gorukle, Bursa, Turkey. saimsag@gmail.com.
authors.forename: Saim
authors.initials: S
authors.lastname: Sag
authors.affiliation: Department of Rheumatology, Uludag University School of Medicine, Gorukle, Bursa, Turkey.
authors.forename: Mustafa Ferhat
authors.initials: MF
authors.lastname: Oksuz
authors.affiliation: Department of Rheumatology, Uludag University School of Medicine, Gorukle, Bursa, Turkey.
authors.forename: Selime
authors.initials: S
authors.lastname: Ermurat
authors.affiliation: Department of Rheumatology, Uludag University School of Medicine, Gorukle, Bursa, Turkey.
authors.forename: Belkis Nihan
authors.initials: BN
authors.lastname: Coskun
authors.affiliation: Department of Nephrology, Uludag University School of Medicine, Gorukle, Bursa, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Gullulu
authors.affiliation: Department of Immunology, Uludag University School of Medicine, Gorukle, Bursa, Turkey.
authors.forename: Ferah
authors.initials: F
authors.lastname: Budak
authors.affiliation: Department of Cardiology, Uludag University School of Medicine, Gorukle, Bursa, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Baran
authors.affiliation: Department of Rheumatology, Uludag University School of Medicine, Gorukle, Bursa, Turkey.
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Pehlivan
authors.affiliation: Department of Rheumatology, Uludag University School of Medicine, Gorukle, Bursa, Turkey.
authors.forename: Ediz
authors.initials: E
authors.lastname: Dalkilic
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000276:immunology / Q000503:physiopathology*; D001323:Autoantibodies; D003240:Connective Tissue Diseases / Q000276:immunology / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012261:Ribonucleoproteins / Q000276:immunology*; D000099207:SS-A Antigen
chemical_list: D001323:Autoantibodies; D012261:Ribonucleoproteins; D000099207:SS-A Antigen
keywords: Anti-Ro52; Arrhythmia; Connective tissue disease; Tpeak-tend; Ventricular repolarization