QT Interval Prolongation in Patients with Systemic Sclerosis-Are the Holter ECG Recordings a Better Option for QT Interval Evaluation?

Sorin Ungurianu,Codrina Ancuta,Doina-Clementina Cojocaru,Robert D Negru,Elena E Saramet

doi:10.3390/medicina57030295

Abstract

Background and Objectives: Cardiac involvement in systemic sclerosis has important consequences on patient survival. Myocardial fibrosis and microcirculation involvement can generate arrhythmic complications, which can be associated with a higher death risk. QT interval prolongation is considered as a risk factor for ectopic ventricular events and can be evaluated using standard short ECG recordings or 24-h Holter ECG recordings. Materials and Methods: 39 patients with systemic sclerosis were submitted to a standard ECG recording at admission and 24-h Holter ECG monitoring. Results: QT interval values resulted from Holter ECG monitoring are higher than the values generated by the short-term ECG recordings. Holter ECG monitoring permits the detection of ventricular ectopy in patients with no events on standard ECG. Conclusions: In patients with systemic sclerosis, 24-h Holter ECG recordings can realize a more precise evaluation of the extent of QTc interval prolongation and ventricular ectopic events associated with myocardial involvement.

Highlights

Systemic sclerosis (SSc)—a disease that has a predominant prevalence in female patients [1], is characterized by an extensive fibrotic process of the conjunctive tissue, which interests multiple organs and by the presence of autoantibodies
The cardiac involvement is usually represented by myocardial fibrosis—some authors are considering that all the patients with systemic sclerosis are having a degree myocardial fibrosis [2], pericardial and coronary microcirculation involvement
Several studies confirmed that in patients with systemic sclerosis, the presence of ventricular arrhythmic events detected on standard short term ECG recordings or Holter ECG recordings is associated with an increased death risk [10,11] and the abnormal Holter results were correlated with the degree of myocardial fibrosis evaluated via delayed enhanced magnetic resonance imaging (DE-MRI) [12]

Summary

Introduction

Systemic sclerosis (SSc)—a disease that has a predominant prevalence in female patients [1], is characterized by an extensive fibrotic process of the conjunctive tissue, which interests multiple organs and by the presence of autoantibodies. Several studies confirmed that in patients with systemic sclerosis, the presence of ventricular arrhythmic events detected on standard short term ECG recordings or Holter ECG recordings is associated with an increased death risk [10,11] and the abnormal Holter results were correlated with the degree of myocardial fibrosis evaluated via delayed enhanced magnetic resonance imaging (DE-MRI) [12]. QT interval prolongation is considered as a risk factor for ectopic ventricular events and can be evaluated using standard short ECG recordings or 24-h Holter ECG recordings. Conclusions: In patients with systemic sclerosis, 24-h Holter ECG recordings can realize a more precise evaluation of the extent of QTc interval prolongation and ventricular ectopic events associated with myocardial involvement

Methods

Results

Discussion

Conclusion