Ventricular late potentials in systemic sclerosis: relationship with skin involvement

• Published in: Journal of rheumatology Vol. 29; no. 7; pp. 1388 - 1392
• Main Authors: PARADISO, Michele, DI FRANCO, Manuela, MUSCA, Antonino, BASILI, Stefania, RICCIERI, Valeria, PAOLETTI, Vincenzo, DE MATTEIS, Antonio, MAMMARELLA, Antonio
• Format: Journal Article
• Language: English
• Published: Toronto, ON The Journal of Rheumatology 01-07-2002; Journal of Rheumatology Publishing
• Subjects: Adult; Biological and medical sciences; Cardiomyopathies - diagnosis; Cardiomyopathies - etiology; Case-Control Studies; Electrocardiography - methods; Female; Humans; Male; Medical sciences; Middle Aged; Probability; Reference Values; Sampling Studies; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Scleroderma, Localized - complications; Scleroderma, Localized - diagnosis; Scleroderma, Systemic - complications; Scleroderma, Systemic - diagnosis; Sensitivity and Specificity; Severity of Illness Index; Signal Processing, Computer-Assisted; Statistics, Nonparametric; Ventricular Function; Human; Immunopathology; Connective tissue disease; Skin disease; Cardiovascular disease; Autoimmune disease; Exploration; Myocardial disease; Thickness measurement; Electrodiagnosis; Symptomatology; Correlation analysis; Heart disease; Systemic disease; Electrocardiography; Complication; Skin; Diagnosis; Predictive factor; Scleroderma
• ISSN: 0315-162X; 1499-2752

OBJECTIVE: To detect the myocardial involvement in patients with systemic sclerosis (SSc) by signal averaged electrocardiography
method (SA-ECG) in relationship to the skin changes. METHODS: We selected 24 SSc outpatients according to American Rheumatism
Association criteria, without clinical and instrumental evidence of cardiac disease, and compared them with 24 control subjects.
All patients and controls underwent SA-ECG to detect ventricular late potentials (LP). The extent and severity of skin involvement
in SSc patients was detected by modified Rodnan (m-Rodnan) skin score. RESULTS: SSc patients had higher prevalence of LP compared
to controls (46 versus 8%, p < 0.003). Median skin score value in the overall SSc population was 7 [mean, SD (range): 7.8,
3.2, (4-18)]. Patients with LP had a higher median skin score value compared to SSc patients without LP [median (range): 10
(6-18) versus 6 (4-9); Mann-Whitney U test 22.5, p < 0.005]. A subset analysis was also performed to verify the correlation
of antibodies positivity (anti-centromere and Scl 70) pattern and the presence of LP. Our findings showed that higher values
of skin score correlated with the presence of LP independent of antibody subsets. CONCLUSIONS: Our data suggest that diffuse
abnormalities of the cardiac tissue detected by SA-ECG may be present, even in patients without cardiac symptoms. The relationship
between LP and skin involvement in patients without clinical evidence of cardiac involvement may help detect of a subset of
patients who may develop scleroderma heart disease.