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THU0206 Clinical significance of qtc dispersion and ejection fraction of the left ventricle in patients with rheumatoid arthritis
  1. BV Obradovic-Tomasevic,
  2. L Radunovic,
  3. K Cobeljic,
  4. V Obradovic
  1. Rheumatology-Cardiology, Clinical Hospital Zemun, University Medical School, Belgrade, Belgrade, Yugoslavia

Abstract

Background QTc dispersion (QTc-d) is an indicator of imbalanced ventricular activity and represents a useful prediction for the appearance of ventricular arrhythmias. The longer QTc-d is more frequent in the patients with the duration of rheumatoid arthritis (RA). Echocardiographically estimated systolic function by ejaction fraction (EF%) has a clinical and therapeutical significance.

Objectives The objective of the research was to examine two groups of patients with RA as regards the duration of the disease to 5 and 10 years.

It was necessary to establish in which group ventricular arrhythmias were more frequent in relation to QTc-d and in relation to EF% as well.

Methods 50 patients were examined, 30 females and 20 females, whose average age of 58 ± 3. All the patients were divided into two groups. The first group included 28 patients with the duration of the diseases to 5 years, and the second group consisted of 22 patients with the duration of the disease from 5 to 10 years. On 12-leed ECG Qtc-d was measured as a difference QTc max – Qtc min and it was corrected by Bazett’s formula. All the measures were done in sinus rhythm. Echocardiographic estimation of the systolic function was determined from EF%, 2-D-Echocardiograpphy.

Results The values of QTc-d in the first group were 50.5 ± 2.5 msec, whereas EF% was 48% ± 3.5.

In the second group QTc-d was 78.5 msec ± 3.2 and EF% was 39% ± 2.5.

The longer QTc-d and lower EF% were noted in all examined patients. However, in the second group of the patients, these values were considerably changed, which indicates that the duration of the disease is important. In the second group the ventricular arrhythmias were more frequent and they are very important in prognosis and treatment of those patients.

Conclusion Exanimated showed that the longer QTc-d was considerably longer in the second group of the patients. EF% was considerably lower in the second group. The longer QTc-d and low EF% were in good correlation with the ventricular arrhythmias.

References

  1. Goldeli O, Dursun E, Komsuoglu B. Dispersion of ventricular repolarization: a new marker of ventricular arrhythmias in patients with rheumatoid arthritis. J Rheunatol. 1998;25(3):447–50

  2. Crawford M, DiMarco J, et al. Cardiology. Mosby, 2001; section 8:5.1‑10

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