Fragmented QRS complex in patients with systemic lupus erythematosus at the time of diagnosis and its relationship with disease activity
Fragmented QRS complex in patients with systemic lupus erythematosus at the time of diagnosis and its relationship with disease activity
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DOI：
10.1371/journal.pone.0227022
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发表时间：
2020-01-02
期刊：
影响因子：
3.7
通讯作者：
Morita, Hiroshi
中科院分区：
文献类型：
--
作者：
Hosonuma, Masahiro;Yajima, Nobuyuki;Morita, Hiroshi
心血管疾病是系统性红斑狼疮（SLE）患者死亡率的重要贡献者，与SLE疾病活动有关。由QRS复合波中的额外尖峰定义的碎裂QRS（fQRS）复合波可用于识别心电图上的心肌瘢痕，并且可以是心脏事件的独立预测因子。我们的目的是评估SLE患者的疾病活动和fQRS在diagnosis. MethodsForty 4例SLE患者之间的关系。排除患有心脏病、其他风湿性疾病和心电图测量时既往接受过治疗的患者。fQRS的出现代表暴露。主要结局是2000年系统性红斑狼疮疾病活动指数（SLEDAI-2K）。进行多元回归分析，以评估之间的关联fQRS和SLEDAI-2K调整的年龄，性别，和时间从估计发病日期到诊断dateofdiagnosis. ResultsAmong SLE患者在诊断，26（59. 1%）有fQRS。fQRS（+）和fQRS（-）组的中位SLEDAI-2K分别为18（四分位距[IQR]，12 - 22）和9（IQR，8 - 15）。fQRS（+）组的SLEDAI-2K显著高于fQRS（-）组（回归系数2.69，95%可信区间0.76-4.61，p = 0.008）。fQRS可能检测SLE患者的亚临床心肌受累，并预测长期心脏事件的发生。
ObjectiveCardiovascular disease is an important contributor to the mortality rate of patients with systemic lupus erythematosus (SLE), which is related to SLE disease activity. Fragmented QRS (fQRS) complexes, defined by additional spikes in the QRS complex, are useful for identifying myocardial scars on electrocardiography and can be an independent predictor of cardiac events. We aimed to assess the relationship between disease activity in patients with SLE and fQRS at the time of diagnosis.MethodsForty-four patients with SLE were included. Patients with cardiac diseases, other rheumatic diseases, and prior treatment at the time of electrocardiography measurement were excluded. The appearance of fQRS represented exposure. The primary outcome was SLE Disease Activity Index 2000 (SLEDAI-2K). Multiple regression analysis was conducted to assess the association between fQRS and SLEDAI-2K adjusted for age, sex, and time from the estimated onset date to the date of diagnosis.ResultsAmong patients with SLE at diagnosis, 26 (59.1%) had fQRS. The median SLEDAI-2K was 18 (interquartile range [IQR], 12-22) and 9 (IQR, 8-15) in the fQRS(+) and fQRS(-) groups, respectively. SLEDAI-2K was significantly higher in the fQRS(+) group than in the fQRS(-) group (regression coefficient, 2.69; 95% confidence interval, 0.76-4.61; p = 0.008).ConclusionOur results suggested that fQRS(+) patients with SLE had high disease activity. fQRS could likely detect subclinical myocardial involvement in patients with SLE and predict long-term occurrence of cardiac events.