Electrocardiographic and Echocardiographic findings and their Relationships in Patients with Systemic Sclerosis

Objectives: Evaluate electrocardiographic and echocardiographic data in asymptomatic patients affected by Systemic Sclerosis (SSc) compared to healthy subjects, to assess their correlations in a case-control study. Methods: 71 female patients affected by SSc (Group A) were compared to 60 healthy female subjects (Group B). Both patients and controls were evaluated by electrocardiogram and trans-thoracic echocardiogram. Results: Patients with the systemic form of disease (dcSSc) showed a longer QT-corrected (QTc) interval (440.58 ± 18.23 msec vs. 427.64 ± 23.12 msec; p = 0.021). The percentage of patients with increased QTc and QTc dispersion (QTcd) values was higher in Group A than in Group B (31.14% vs 14.03%, p = 0.03; 36.06% vs. 1.75%, p <0.001). Left ventricular mass index (LVMI) was higher in group A (80.50 ± 20.59 g/m2 vs. 61.54 ± 11.08 g/m2 ; p<0.0001). Left ventricular ejection fraction (LVEF) was higher in control subjects (63.55 ± 6.58 % vs. 68.42 ± 5.99 %, p <0.001).Left ventricular diastolic dysfunction (LVDD) was more prevalent in group A (70.5% vs. 29.82%, p= 0.001). In Group A, QTc prolongation was associated with LVDD (78.94% vs. 12.5%, p = 0.002). Increased QTc and QTcd were associated with higher LVMI values (p≤ 0.05). Conclusions: In asymptomatic patients affected by SSc, a P wave duration ≥ 110 msec and/or a QTc ≥450 msec and/or QTcd >60 msec appear to be associated with early myocardial damage. The identification of markers of early cardiac involvement during SSc could allow appropriate prevention strategies against advanced forms of disease.