Fragmented QRS complex in patients with systemic lupus erythematosus at the time of diagnosis and its relationship with disease activity


Autoři: Masahiro Hosonuma aff001;  Nobuyuki Yajima aff001;  Ryo Takahashi aff001;  Ryo Yanai aff001;  Taka-aki Matsuyama aff004;  Eiji Toyosaki aff005;  Jumpei Saito aff006;  Kengo Kusano aff007;  Hiroshi Morita aff008
Působiště autorů: Division of Rheumatology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan aff001;  Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine and Public Health, Kyoto, Japan aff002;  Center for Innovative Research for Communities and Clinical Excellence, Fukushima Medical University, Fukushima, Japan aff003;  Department of Legal Medicine, Showa University, School of Medicine, Tokyo, Japan aff004;  Division of Cardiology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan aff005;  Division of Cardiology, Showa University Northern Yokohama Hospital, Yokohama, Japan aff006;  Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan aff007;  Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan aff008
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
prolekare.web.journal.doi_sk: 10.1371/journal.pone.0227022

Souhrn

Objective

Cardiovascular disease is an important contributor to the mortality rate of patients with systemic lupus erythematosus (SLE), which is related to SLE disease activity. Fragmented QRS (fQRS) complexes, defined by additional spikes in the QRS complex, are useful for identifying myocardial scars on electrocardiography and can be an independent predictor of cardiac events. We aimed to assess the relationship between disease activity in patients with SLE and fQRS at the time of diagnosis.

Methods

Forty-four patients with SLE were included. Patients with cardiac diseases, other rheumatic diseases, and prior treatment at the time of electrocardiography measurement were excluded. The appearance of fQRS represented exposure. The primary outcome was SLE Disease Activity Index 2000 (SLEDAI-2K). Multiple regression analysis was conducted to assess the association between fQRS and SLEDAI-2K adjusted for age, sex, and time from the estimated onset date to the date of diagnosis.

Results

Among patients with SLE at diagnosis, 26 (59.1%) had fQRS. The median SLEDAI-2K was 18 (interquartile range [IQR], 12–22) and 9 (IQR, 8–15) in the fQRS(+) and fQRS(-) groups, respectively. SLEDAI-2K was significantly higher in the fQRS(+) group than in the fQRS(-) group (regression coefficient, 2.69; 95% confidence interval, 0.76–4.61; p = 0.008).

Conclusion

Our results suggested that fQRS(+) patients with SLE had high disease activity. fQRS could likely detect subclinical myocardial involvement in patients with SLE and predict long-term occurrence of cardiac events.

Klíčová slova:

Antibodies – Cardiovascular diseases – Complement system – Electrocardiography – Inflammatory diseases – Myocardial infarction – Regression analysis


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