Electrocardiographic Findings in Systemic Lupus Erythematosus: Data From an International Inception Cohort

被引:34
作者
Bourre-Tessier, Josiane [1 ]
Urowitz, Murray B. [2 ,3 ]
Clarke, Ann E. [4 ]
Bernatsky, Sasha [4 ]
Krantz, Mori J. [5 ]
Thao Huynh [6 ]
Joseph, Lawrence [6 ]
Belisle, Patrick [6 ]
Bae, Sang-Cheol [7 ]
Hanly, John G. [8 ,9 ]
Wallace, Daniel J. [10 ]
Gordon, Caroline [11 ]
Isenberg, David [12 ]
Rahman, Anisur [12 ]
Gladman, Dafna D. [2 ,3 ]
Fortin, Paul R. [13 ]
Merrill, Joan T. [14 ]
Romero-Diaz, Juanita [15 ]
Sanchez-Guerrero, Jorge [15 ]
Fessler, Barri [16 ]
Alarcon, Graciela S. [16 ]
Steinsson, Kristjan [17 ]
Bruce, Ian N. [18 ]
Ginzler, Ellen [19 ]
Dooley, Mary Anne [20 ]
Nived, Ola [21 ]
Sturfelt, Gunnar [21 ]
Kalunian, Kenneth [22 ]
Ramos-Casals, Manuel [23 ]
Petri, Michelle [24 ]
Zoma, Asad [25 ]
Pineau, Christian A. [4 ]
机构
[1] Univ Montreal, Ctr Hlth, Montreal, PQ, Canada
[2] Toronto Western Hosp, Univ Hlth Network, Toronto, ON M5T 2S8, Canada
[3] Univ Toronto, Toronto, ON, Canada
[4] Montreal Gen Hosp, Montreal, PQ H3G 1A4, Canada
[5] Univ Colorado, Denver, CO 80202 USA
[6] McGill Univ, Ctr Hlth, Montreal, PQ, Canada
[7] Hanyang Univ, Hosp Rheumat Dis, Seoul 133791, South Korea
[8] Queen Elizabeth II Med Ctr, Halifax, NS, Canada
[9] Dalhousie Univ, Halifax, NS, Canada
[10] Cedars Sinai Med Ctr, Los Angeles, CA 90048 USA
[11] Univ Birmingham, Birmingham, W Midlands, England
[12] UCL, London, England
[13] Univ Laval, Ctr Hosp Univ Quebec, Quebec City, PQ, Canada
[14] Oklahoma Med Res Fdn, Oklahoma City, OK 73104 USA
[15] Natl Inst Nutr, Mexico City, DF, Mexico
[16] Univ Alabama Birmingham, Birmingham, AL USA
[17] Landspitali Univ Hosp, Reykjavik, Iceland
[18] Univ Manchester, Manchester Musculoskeletal Biomed Res Unit, Manchester, Lancs, England
[19] SUNY Hlth Sci Ctr, Brooklyn, NY USA
[20] Univ N Carolina, Chapel Hill, NC USA
[21] Univ Lund Hosp, S-22185 Lund, Sweden
[22] Univ Calif San Diego, San Diego, CA 92103 USA
[23] Serv Enfermedades Autoinmunes, Barcelona, Spain
[24] Johns Hopkins Univ, Baltimore, MD USA
[25] Stonehouse Hosp, Glasgow, Lanark, Scotland
基金
英国惠康基金; 加拿大健康研究院;
关键词
CORRECTED QT INTERVAL; CONGENITAL HEART-BLOCK; ANTI-RO/SSA; CARDIAC-ARRHYTHMIAS; POSITIVE ADULTS; RISK-FACTORS; PROLONGATION; DISEASE; ANTIBODIES; DISPERSION;
D O I
10.1002/acr.22370
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective. To estimate the early prevalence of various electrocardiographic (EKG) abnormalities in patients with systemic lupus erythematosus (SLE) and to evaluate possible associations between repolarization changes (increased corrected QT [QTc] and QT dispersion [QTd]) and clinical and laboratory variables, including the anti-Ro/SSA level and specificity (52 or 60 kd). Methods. We studied adult SLE patients from 19 centers participating in the Systemic Lupus International Collaborating Clinics (SLICC) Inception Registry. Demographics, disease activity (Systemic Lupus Erythematosus Disease Activity Index 2000 [SLEDAI-2K]), disease damage (SLICC/American College of Rheumatology Damage Index [SDI]), and laboratory data from the baseline or first followup visit were assessed. Multivariate logistic and linear regression models were used to asses for any cross-sectional associations between anti-Ro/SSA and EKG repolarization abnormalities. Results. For the 779 patients included, mean +/- SD age was 35.2 +/- 13.8 years, 88.4% were women, and mean +/- SD disease duration was 10.5 +/- 14.5 months. Mean +/- SD SLEDAI-2K score was 5.4 +/- 5.6 and mean +/- SD SDI score was 0.5 +/- 1.0. EKG abnormalities were frequent and included nonspecific ST-T changes (30.9%), possible left ventricular hypertrophy (5.4%), and supraventricular arrhythmias (1.3%). A QTc >= 440 msec was found in 15.3%, while a QTc >= 460 msec was found in 5.3%. Mean +/- SD QTd was 34.2 +/- 14.7 msec and QTd >= 40 msec was frequent (38.1%). Neither the specificity nor the level of anti-Ro/SSA was associated with QTc duration or QTd, although confidence intervals were wide. Total SDI was significantly associated with a QTc interval exceeding 440 msec (odds ratio 1.38 [95% confidence interval 1.06, 1.79]). Conclusion. A substantial proportion of patients with recent-onset SLE exhibited repolarization abnormalities, although severe abnormalities were rare.
引用
收藏
页码:128 / 135
页数:8
相关论文
共 36 条
[1]  
Bazett HC, 1920, HEART-J STUD CIRC, V7, P353
[2]   DERIVATION OF THE SLEDAI - A DISEASE-ACTIVITY INDEX FOR LUPUS PATIENTS [J].
BOMBARDIER, C ;
GLADMAN, DD ;
UROWITZ, MB ;
CARON, D ;
CHANG, CH .
ARTHRITIS AND RHEUMATISM, 1992, 35 (06) :630-640
[3]   Prolonged Corrected QT Interval in Anti-Ro/SSA-Positive Adults With Systemic Lupus Erythematosus [J].
Bourre-Tessier, Josiane ;
Clarke, Ann E. ;
Thao Huynh ;
Bernatsky, Sasha ;
Joseph, Lawrence ;
Belisle, Patrick ;
Pineau, Christian A. .
ARTHRITIS CARE & RESEARCH, 2011, 63 (07) :1031-1037
[4]   Impaired fasting glucose, diabetes mellitus, and cardiovascular disease risk factors are associated with prolonged QTc duration. Results from the Third National Health and Nutrition Examination Survey [J].
Brown, DW ;
Giles, WH ;
Greenlund, KJ ;
Valdez, R ;
Croft, JB .
JOURNAL OF CARDIOVASCULAR RISK, 2001, 8 (04) :227-233
[5]   Neonatal lupus: Basic research and clinical perspectives [J].
Buyon, JP ;
Clancy, RM .
RHEUMATIC DISEASE CLINICS OF NORTH AMERICA, 2005, 31 (02) :299-+
[6]   Concomitant disappearance of electrocardiographic abnormalities and of acquired maternal autoantibodies during the first year of life in infants who had QT interval prolongation and anti-SSA/Ro positivity without congenital heart block at birth [J].
Cimaz, R ;
Meroni, PL ;
Brucato, A ;
Fesstovà, V ;
Panzeri, P ;
Goulene, K ;
Stramba-Badiale, M .
ARTHRITIS AND RHEUMATISM, 2003, 48 (01) :266-268
[7]   Impaired clearance of apoptotic cardiocytes is linked to anti-SSA/Ro and -SSB/La antibodies in the pathogenesis of congenital heart block [J].
Clancy, Robert M. ;
Neufing, Petra J. ;
Zheng, Ping ;
O'Mahony, Marguerita ;
Nimmerjahn, Falk ;
Gordon, Tom P. ;
Buyon, Jill P. .
JOURNAL OF CLINICAL INVESTIGATION, 2006, 116 (09) :2413-2422
[8]   Corrected QT interval in anti-SSA-positive adults with connective tissue disease: Comment on the article by Lazzerini et al [J].
Costedoat-Chalumeau, N ;
Amoura, Z ;
Hulot, JS ;
Ghillani, P ;
Lechat, P ;
Funck-Brentano, C ;
Piette, JC .
ARTHRITIS AND RHEUMATISM, 2005, 52 (02) :676-677
[9]   Prevalences of ECG findings in large population based samples of men and women [J].
De Bacquer, D ;
De Backer, G ;
Kornitzer, M .
HEART, 2000, 84 (06) :625-633
[10]  
Drew BJ, 2010, J AM COLL CARDIOL, V55, P934, DOI [10.1016/j.jacc.2010.01.001, 10.1161/CIRCULATIONAHA.109.192704]