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Cardiac abnormalities seen on EKG in patients with SLE
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Patients with systemic lupus erythematosus presented with cardiac abnormalities in electrocardiographic studies — even those with short disease duration; however, serious abnormalities were rare, according to newly published research.
Researchers studied 779 patients with systemic lupus erythematosus (SLE) enrolled in the Systemic Lupus International Collaborating Clinics (SLICC) Inception Registry, a study conducted at 19 centers in eight countries with yearly follow-up between October 1999 and December 2008. Mean patient age was 35.2 years, and mean disease duration was 10.5 months. Electrocardiograph (EKG) data was analyzed by three independent cardiologists. Anti-Ro/SSA were present in 47.3% of the patients, among whom 30.2% were positive for anti-Ro/SSA 52, 44.2% were positive for anti-Ro/SSA 60 and 27% were positive for both.
Covariate data were collected and included age, sex, disease duration, Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) and disease damage (SLICC/American College of Rheumatology Damage Index [SDI]) scores, arterial hypertension, history of cardiovascular health and pertinent medications such as use of NSAIDs, antimalarials, calcium channel blockers, steroid and others. Laboratory data included tests for antibodies associated with SLE and others.
Patients’ mean ± SD SLEDAI-2K and mean ± SD SDI scores were 5.4 and 0.5, respectively. The researchers found EKG abnormalities were frequent and included non-specific ST-T changes in 30.9% of patients, possible left ventricular hypertrophy in 5.4% of patients and supraventricular arrhythmias in 1.3% of patients.
Slightly more than 15% of patients had an increased corrected QT (QTc) of 440 msec or greater, whereas 5.3% of patients had a QTc of 460 or greater. Patients’ mean ± SD QT dispersion (QTd) was 34.2 msec, and 38.1% of patients had a QTd of 40 msec or greater, according to the researchers.
Neither QTc duration nor QTd were found to be associated with specificity or the level of anti-Ro/SSA; however, confidence intervals were considered wide.
The researchers found total SDI had a significant association with QTc intervals that exceeded 440 msec.
Among women between the ages of 25 and 44 years, mean prevalence of atrioventricular block was similar to healthy women of the same age (0.85% vs. 0.1%, respectively) but higher for bundle branch block (4.79% vs. 0.2%) and in left ventricular hypertrophy (4.2% vs. 0.04%). – by Shirley Pulawski
Disclosure: Bourre-Tessier has no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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