Περίληψη:
The heart has been generally recognized as a target organ in progressive
systemic sclerosis. Noninvasive studies have assessed the incidence and
prognostic importance of cardiac arrhythmias in these patients. However,
detailed exploration of the function of impulse formation and the
conduction system of the heart in these patients has never been
reported. Therefore, invasive electrophysiologic studies were performed
in 30 patients with systemic sclerosis, all of whom had neither obvious
cardiac involvement nor cardiac arrhythmias, and in 32 subjects with no
evidence of heart disease, who served as a control group. Corrected
sinus node recovery time in patients with systemic sclerosis was
significantly longer (P < .001) than in the control group, as was the HV
interval (P < .05). Of the 30 patients with systemic sclerosis, 10 had
an HV interval of 60 ms or longer. In four patients with systemic
sclerosis, the recorded AH interval exceeded 125 ms. The intra-atrial
conduction time tended to increase to a significant degree (P < .05) in
patients with systemic sclerosis. The interatrial conduction time was
much longer (P < .001), and the maximal conduction delay to the
atrioventricular junction and to the distal coronary sinus was much
greater in the patients with systemic sclerosis than in the control
group (P < .001 for both). Supraventricular tachyarrhythmias were
induced in 15 patients with systemic sclerosis versus 3 control group
subjects (P < .001). With respect to corrected sinus node recovery time,
AH and HV intervals, atrial vulnerability, and ventricular tachycardia,
3 of the 30 patients with systemic sclerosis had abnormal Endings in one
of these parameters and 14 had abnormalities in more than one. These
results suggest that a broad spectrum of electrophysiologic
abnormalities is present in patients with systemic sclerosis, which can
be revealed only by invasive studies. Furthermore, this study provides
additional support for the hypothesis that diffuse myocardial
involvement is characteristic of scleroderma patients, since a number of
these patients showed more than one electrophysiologic defect.
Συγγραφείς:
Rokas, S
Mavrikakis, M
Agrios, N
Mylonas, D
Antoniadou,
L
Moulopoulos, S
