In systemic sclerosis prolonged QTc interval is associated with reduced exercise tolerance

Abstract

In systemic sclerosis (SSc) primary cardiac involvement may manifest as fibrosis of the conduction system, myocardial and pericardial involvement, arrhythmias, pacemaker and intracardiac defibrillator implantation, sudden death and autonomic dysfunction [ 1 Lambova S. Cardiac manifestations in systemic sclerosis. World J Cardiol. 2014; 6: 993-1005 Crossref PubMed Google Scholar , 2 Gigante Rosato E. Liberatori M. et al. Autonomic dysfunction in patients with systemic sclerosis: correlation with intrarenal arterial stiffness. Int J Cardiol. 2014; 177: 578-580 Abstract Full Text Full Text PDF PubMed Scopus (22) Google Scholar ]. Recently, QTc interval prolongation was found in SSc patients without clinical cardiac involvement and in the absence of echographic abnormalities. In fact, in SSc patients has been observed that QTc interval prolongation correlate with capillaroscopic pattern, with digital ulcers and with skin thickening score [ [3] Rosato E. Gigante A. Liberatori M. et al. QTc interval prolongation in systemic sclerosis: correlations with clinical variables. Int J Cardiol. Mar 1 2015; 182: 20-22 Abstract Full Text Full Text PDF PubMed Scopus (11) Google Scholar ]. Also, Rosato et al. showed in a cohort of SSc patients without cardiac and pulmonary involvement, a high prevalence of reduced exercise tolerance [ [4] Rosato E. Romaniello A. Magrì D. et al. Exercise tolerance in systemic sclerosis patients without pulmonary impairment: correlation with clinical variables. Clin Exp Rheumatol. 2014; 32 (S-103-8) PubMed Google Scholar ], while Gigante et al. for the first time have demonstrated that a correlation exists between increased intrarenal stiffness and pulmonary vasculopathy characterized by impairment of blood flow during exercise [ [5] Gigante A. Romaniello A. Magrì D. et al. Correlation between intrarenal arterial stiffness and exercise tolerance in systemic sclerosis patients without renal and cardiopulmonary impairment: the role of the microvascular damage. Int J Cardiol. 2015; 15: 122-124 Abstract Full Text Full Text PDF Scopus (6) Google Scholar ]. Accordingly, the aim of the present study is to assess QTc prolongation in SSc and evaluate correlations with cardiopulmonary exercise test (CPET) in patients without pulmonary and cardiac involvement.