Background Cardiac involvement in Systemic Sclerosis (SSc) is rather common and it can be considered a bad prognostic feature.
Objectives In this study we aimed to evaluate this involvement performing electrocardiogram (ECG) and echocardiogram in a group of SSc patients, comparing their data with those of healthy volunteers (NC).
Methods Seventy-one consecutive SSc patients (Group A) were compared to 60 NC (Group B), matched for age and sex. Both patients and NC were evaluated by anamnesis, physical examination, ECG and trans-thoracic echocardiogram, with Doppler and tissue-wave Doppler.
Results Ten SSc patients and 3 NC were excluded (Group A: 4 patients for increased basal heart rate, 2 for TAPSE <17 mm, 3 for valvular disease and 1 patient for severe pulmonary hypertension. Group B: 3 subjects for high basal heart rate). Among SSc patients 22 (36.1%) had a diffuse cutaneous form (dcSSc), and 39 (73.9%) had a limited cutaneous form (lcSSc). In table 1 clinical-demographic and laboratory features of patients are described. QT dispersion (QTd) and QTc dispersion (QTcd) were significantly higher in Group A respect to Group B (QTd 49.83 vs 27.85 msec, p<0.0001; QTcd: 51.39 vs 29.73 msec, p<0.0001). Patients with dcSSc showed longer QTc values than controls (440.58±18.23 vs 427.64±23.12 msec, p=0.02). Left ventricular mass index (LVMI) mean values were significantly increased while left ventricular ejection fraction (LVEF) mean values were significantly reduced in Group A compared with Group B respectively (LVMI: 80.5 vs 61.54 g/m2, p<0.0001; LVEF: 63.55 vs 68.42%, p=0.0001). No patient with LVEF<55% was found. In addition left atrial volume index for body surface (LAVI) mean values were higher in Group A (27.67 vs 18.78 ml/m2, p<0.0001). The percentage of patients with left ventricular diastolic dysfunction (LVDD) was higher in Group A (70.5 vs 21.8%, p=0.0001). In Group A QTc prolungation, increased levels of QTcd and P wave duration were associated with LVDD. An increase of P-wave duration was also associated with higher values of LAVI (p=0.04).
Conclusions Significant cardiological differences can be found in SSc, even in asymptomatic patients, respect to NC, thus confirming how ECG and echocardiogram are relevant instruments able to detect morpho-functional abnormalities suggestive of an early myocardial involvement in this disease.
Disclosure of Interest None declared