Background Cardiac blocks (CBs) (atrioventricular blocks, left bundle branch block, left anterior fascicle block ± right bundle block) are known to reflect myocardial fibrosis in patients with Systemic Sclerosis (SSc). Their prevalence has been already assessed in EUSTAR cohort on 3656 patients (1). Nevertheless, only a few associated features were investigated.
Objectives To assess the prevalence of CBs in a larger series and investigate associated clinical and therapeutic features.
Methods Data from 10183 SSc patients (87% females, 13% males; 31% diffuse disease, 69% limited disease); aged from10-91 years-median age 56; with a disease duration ranging from (0.83-76 years - median 9 years) entered in the EUSTAR MEDS-online system, the largest online SSc database in the world, from 2003 to July 2012 were analyzed retrospectively. CBs as well as other epidemiological, clinical and therapeutic aspects were deduced from Minimal Essential Data Set charts.
Results CBs were detected at enrollment in 968 patients (10%). In univariate analysis CBs were found to be associated with epidemiological [ male sex ( OR 1.6, 1.4-1.9); age <56 (median age at presentation) (OR 1.81, 1.58-2.08)]; clinical [diffuse disease (OR 1.28, 1.12-1.47); anti-Scl-70 positivity (OR 1.45, 1.26-1.60); interstitial lung disease (OR 1.35, 1.05-1.73); tendon friction rubs (OR 1.5; CI 1.2-1.9); articular involvement (OR 2.0, CI 1.7-2.3); renal involvement (OR 2.1, CI 1.5-3.1); and other features reflecting myocardial fibrosis such as an inversion E/A ratio (OR 3.49, 3-4) and LVEF <50% (OR 2.89, 1.68-4.98)] and therapeutic [CCB, ACE inhibitor use]. In multivariate analysis CB were significantly associated with male sex (p<0.0001), anti-Scl70 positivity (p=0.0004) only.
Conclusions We confirm the already reported association of CCBs with anti-Scl-70 positivity. The detected association with CCB and ACE is likely to reflect confounding for indication.
Walker UA, Tyndall A, Czirjak L. Ann Rheum Dis 2007; 66:754-63
Disclosure of Interest None Declared