PDF(Pubmed)
Abstract：
In systemic sclerosis (SSc), fibrosis of the myocardium along with ongoing autoimmune inflammation can alter the electric function of the cardiac myocytes, which may increase the risk for ventricular arrhythmias and sudden cardiac death. We analyzed the electrocardiographic (ECG) variables describing ventricular repolarization such as QT interval, QT dispersion (QTd), T wave peak-to-end interval (Tpe), and arrhythmogeneity index (AIX) of 26 patients with SSc and 36 healthy controls. Furthermore, echocardiographic and laboratory parameters were examined, with a focus on inflammatory proteins like C-reactive ptotein (CRP), soluble intracellular adhesion molecule-1 (sICAM-1), soluble vascular adhesion molecule-1 (sVCAM-1), and progranulin (PGRN). The CRP, sICAM-1, and sVCAM-1 levels were positively correlated with the length of the QT interval. Although the serum PGRN levels were not increased in the SSc group compared to the controls, in SSc patients, the PGRN levels were positively correlated with the QT interval and the AIX. According to our results, we conclude that there may be a potential association between autoimmune inflammation and the risk for ventricular arrhythmias in patients with SSc. We emphasize that the measurement of laboratory parameters of inflammatory activity including CRP, PGRN, sVCAM-1, and sICAM-1 could be helpful in the prediction of sudden cardiac death in patients with SSc.
摘要：
在系统性硬化症（SSc）中，心肌纤维化以及持续的自身免疫性炎症可以改变心肌细胞的电功能，这可能会增加室性心律失常和心源性猝死的风险。我们分析了描述心室复极的心电图（ECG）变量，例如QT间期，QT离散度(QTd),T波峰端间隔(Tpe),26例SSc患者和36例健康对照者的心律失常性指数（AIX）。此外，检查了超声心动图和实验室参数，关注炎症蛋白，如C反应蛋白（CRP），可溶性细胞内粘附分子-1（sICAM-1），可溶性血管粘附分子-1（sVCAM-1），和前颗粒蛋白（PGRN）。CRP,sICAM-1和sVCAM-1水平与QT间期长度呈正相关。尽管与对照组相比，SSc组的血清PGRN水平没有增加，在SSc患者中，PGRN水平与QT间期和AIX呈正相关。根据我们的结果,我们得出的结论是,自身免疫性炎症与SSc患者室性心律失常的风险之间可能存在潜在关联.我们强调，包括CRP在内的炎症活动的实验室参数的测量，PGRN,sVCAM-1和sICAM-1可能有助于预测SSc患者的心源性猝死。
