P6381Fragmented QRS complex in Systemic Sclerosis Patients: Correlations with Clinical Complications

Abstract

Background: Systemic Sclerosis (SSc) is a connective tissue disease characterized by vascular dysfunction and excessive fibrosis involving the skin and visceral organs. Visceral involvement, including cardiac manifestations, interstitial lung disease (ILD) and pulmonary hypertension (PH) can lead to severe clinical complications. We hypothesized that fragmented QRS complex (fQRS) in 12-lead ECG is potentially attributed to cardiac involvement in SSc patients. Purpose: The aim of the study was to investigate the frequency of fQRS in SSc patients, in relationship to other complications. Methods: The present study enrolled 69 consecutive SSc patients (56 females, 62±14 years) without obvious cardiac disease and 69 healthy control subjects whose age, gender, left ventricular ejection fraction (LVEF) were matched to the SSc patients. We evaluated for the presence of fQRS in 12-lead ECG and the parameters of transthoracic echocardiography. The respiratory function test, the presence of ILD on chest computed tomography and the presence of PH were also analyzed in SSc patients. Results: SSc patients had higher prevalence of fQRS compared to control subjects (61% vs 4%, p<0.001). No differences were seen in parameters of echocardiography and serum B-type natriuretic peptide (BNP) levels between the SSc patients and the control subjects. In the SSc patients, fQRS group had significantly greater number of the patients with LV diastolic dysfunction (54% vs 18%, OR, 5.33; 95% CI 1.74-16.16, p=0.003), ILD (76% vs 32%, OR, 6.54; 95% CI 2.28-18.77, p<0.001), PH (24% vs 0%, p=0.005), compared to those with the non-fQRS group. There were no differences in PQ, QRS and QTc duration in 12-lead ECG between the SSc patients with and without fQRS. No significant difference was observed regarding duration of disease, LVEF, serum BNP levels and parameters in respiratory function test between the 2 groups. Conclusions: The prevalence of fQRS in SSc patients was high, suggesting potentially subclinical cardiac involvement. The relationship between fQRS and respiratory abnormalities may help detect the patients who develop scleroderma lung disease.