[go: up one dir, main page]
More Web Proxy on the site http://driver.im/ Skip to main content
Springer Nature Link
Log in

Prevalence of resting-ECG abnormalities in systemic lupus erythematosus: a single-center experience

  • Original Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

Cardiovascular complications are a major cause of morbidity and even mortality among systemic lupus erythematosus (SLE) patients. Whether cardiac arrhythmias contribute to this burden among SLE patients, however, is not currently known. The goal of this study was to determine the prevalence of cardiac conduction abnormalities among SLE patients from a single center. We retrospectively reviewed the medical records of SLE patients who had 12-lead electrocardiograms (ECGs) available from various settings at a single academic center over the period of 10 years. In addition, ICD-9 codes for arrhythmias were obtained for the SLE patients whose ECGs were reviewed. The hospital setting (in-patient, out-patient, emergency department) and the indication for obtaining the ECG were evaluated. Two hundred thirty-five SLE patients had available ECGs. Sinus tachycardia was most common (18%). With direct ECG review, tachyarrhythmias were found in 6% of SLE patients, with the most common being atrial fibrillation (3%). Atrial fibrillation was seen even more frequently (9%) when ICD-9 codes were reviewed. No patients had brady-arrhythmias. QT prolongation was present in 17% of patients upon direct ECG review. More ECGs with tachyarrhythmias and QT prolongation were found among inpatients, with preoperative evaluation and gastrointestinal symptoms being the most common indications. Sinus tachycardia was the most common finding seen among our SLE patients with ECGs. Further study into the possible mechanisms behind this is warranted, including the possibility of autonomic nervous system involvement in SLE.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
£29.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (United Kingdom)

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Miner JJ, Kim AHJ (2014) Cardiac manifestations of systemic lupus erythematosus. Rheum Dis Clin N Am 40(1):51–60. doi:10.1016/j.rdc.2013.10.003

    Article  Google Scholar 

  2. Hak AE, Karlson EW, Feskanich D, Stampfer MJ, Costenbader KH (2009) Systemic lupus erythematosus and the risk of cardiovascular disease: results from the nurses’ health study. Arthritis Rheum 61:1396–1402.​ doi: 10.1002/art.24537

  3. Straus SMJM, Kors JA, De Bruin ML et al (2006) Prolonged QTc interval and risk of sudden cardiac death in a population of older adults. J Am Coll Cardiol 47(2):362–367. doi:10.1016/j.jacc.2005.08.067

    Article  PubMed  Google Scholar 

  4. Benjamin EJ, D’Agostino RB, Silbershatz H, Kannel WB, Levy DWPA (1998) Impact of atrial fibrillation on the risk of death: the Framingham heart study. Circulation 98(10):946–952

  5. Montanez A, Ruskin JN, Hebert PR, Lamas GA, Hennekens CH (2004) Prolonged QTc interval and risks of total and cardiovascular mortality and sudden death in the general population: a review and qualitative overview of the prospective cohort studies. Arch Intern Med 164(9):943–948. doi:10.1001/archinte.164.9.943

    Article  PubMed  Google Scholar 

  6. Go AS, Hylek EM, Phillips KA et al (2001) Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and risk factors in atrial fibrillation (ATRIA) study. JAMA 285(18):2370–2375. doi:10.1001/jama.285.18.2370

    Article  CAS  PubMed  Google Scholar 

  7. Hochberg MC (1997) Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 40(9):1725. doi:10.1002/1529-0131(199709)40:9<1725::AID-ART29>3.0.CO;2-Y

    Article  CAS  PubMed  Google Scholar 

  8. US Department of Health and Human Services Food and Drug Administration (2005). Guidance for industry: E14 clinical evaluation of QT/QTc interval prolongation and proarrhythmic potential for non-antiarrhythmic drugs

  9. Vetter VL (2007) Clues or miscues? How to make the right interpretation and correctly diagnose long-QT syndrome. Circulation 115(20):2595–2598. doi:10.1161/CIRCULATIONAHA.107.700195

    Article  PubMed  Google Scholar 

  10. Utset TO, Ward AB, Thompson TL, Green SL (2013) Significance of chronic tachycardia in systemic lupus erythematosus. Arthritis Care Res 65(5):827–831. doi:10.1002/acr.21902

    Article  Google Scholar 

  11. Aydemir M, Yazisiz V, Basarici I et al (2010) Cardiac autonomic profile in rheumatoid arthritis and systemic lupus erythematosus. Lupus 19(3):255–261. doi:10.1177/0961203309351540

    Article  CAS  PubMed  Google Scholar 

  12. Koopman FA, Chavan SS, Miljko S et al (2016) Vagus nerve stimulation inhibits cytokine production and attenuates disease severity in rheumatoid arthritis. Proc Natl Acad Sci U S A 113(29):8284–8289. doi:10.1073/pnas.1605635113

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Levy MN (1990) Autonomic interactions in cardiac control. Ann N Y Acad Sci 601:209–221. doi:10.1111/j.1749-6632.1990.tb37302.x

    Article  CAS  PubMed  Google Scholar 

  14. Thayer JF, Lane RD (2007) The role of vagal function in the risk for cardiovascular disease and mortality. Biol Psychol 74(2):224–242. doi:10.1016/j.biopsycho.2005.11.013

    Article  PubMed  Google Scholar 

  15. Bourre-Tessier J, Urowitz MB, Clarke AE et al (2014) Electrocardiographic findings in systemic lupus erythematosus: data from an international inception cohort. Arthritis Care Res (Hoboken). doi:10.1002/acr.22370

    Google Scholar 

  16. Gómez-Barrado JJ, García-Rubira JC, Polo Ostáriz MA, Turégano Albarrán S (2002) Complete atrioventricular block in a woman with systemic lupus erythematosus. Int J Cardiol 82(3):289–292

    Article  PubMed  Google Scholar 

  17. Mymin D, Mathewson FA, Tate RB, Manfreda J (1986) The natural history of primary first-degree atrioventricular heart block. N Engl J Med 315(19):1183–1187. doi:10.1056/NEJM198611063151902

    Article  CAS  PubMed  Google Scholar 

  18. Khan IA (2002) Long QT syndrome: diagnosis and management. Am Heart J 143(1):7–14. doi:10.1067/mhj.2002.120295

    Article  PubMed  Google Scholar 

  19. Straus SMJM, Sturkenboom MCJM, Bleumink GS et al (2005) Non-cardiac QTc-prolonging drugs and the risk of sudden cardiac death. Eur Heart J 26(19):2007–2012. doi:10.1093/eurheartj/ehi312

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Rheumatology/Department of Internal Medicine, University of California-Los Angeles, 1000 Veteran Ave, Los Angeles, CA, 90024, USA

    Gihyun Myung

  2. Division of Rheumatology/Department of Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA

    Lindsy J. Forbess, Mariko L. Ishimori, Daniel Wallace & Michael H. Weisman

  3. Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA

    Sumeet Chugh

Authors
  1. Gihyun Myung
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lindsy J. Forbess
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mariko L. Ishimori
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sumeet Chugh
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Daniel Wallace
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Michael H. Weisman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gihyun Myung.

Ethics declarations

Financial support

None

Disclosures

None.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Myung, G., Forbess, L.J., Ishimori, M.L. et al. Prevalence of resting-ECG abnormalities in systemic lupus erythematosus: a single-center experience. Clin Rheumatol 36, 1311–1316 (2017). https://doi.org/10.1007/s10067-017-3582-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-017-3582-0

Keywords