Bundle Branch Blocks and Fragmented QRS Complex in Iranian Patients with Systemic Sclerosis

  • Ali Javinani Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Zahra Javady Nejad Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Farhad Gharibdoost Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Ahmad Reza Jamshidi Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Reza Atef Yekta Anesthesiology Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Saba Alvand Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Vahide Imeni Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Seyed Naser Hashemi Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Hoda Kavosi Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Keywords: Systemic sclerosis, fragmented QRS complex, bundle branch blocks

Abstract

Background: Cardiac involvement, as one of the life-threatening manifestations of systemic sclerosis (SSc), is chiefly caused by collagen fiber deposition in the myocardium, which subsequently leads to conduction abnormalities. In the present study, we aimed to investigate the prevalence and clinical significance of bundle branch blocks (BBBs) and the fragmented QRS complex (fQRS) in Iranian patients with SSc. Methods: Forty-one patients with SSc were enrolled from the outpatient SSc clinic of Shariati Hospital, Tehran University of Medical Sciences, between October 2016 and February 2017. Twelve-lead ECG was obtained and interpreted for BBBs and the fQRS. To adjust for the confounding effects of non–SSc-related cardiovascular risk factors, we calculated the Framingham risk score to estimate the risk of cardiovascular diseases. The associations between the studied conduction abnormalities and SSc cutaneous subtypes; disease duration; and the Medsger SSc severity scale of cutaneous, pulmonary, and vascular involvements were also analyzed. Results: The study population consisted of 41 Iranian patients with SSc at a mean age of 47.48±11.57 years (82.9% female). The prevalence of BBBs and the fQRS was 26.8% and 36.6%, respectively. The fQRS was associated with the limited cutaneous SSc subtype (OR: 0.100, 95%CI: 0.018–0.553, and P=0.028). BBBs and the fQRS were not associated with either the Framingham risk score or the rest of the clinicodemographic variables. Conclusion:  BBBs and the fQRS were more prevalent in our patients with SSc, without any association with the involvement of the other organs. These findings may suggest the independent pathophysiology of cardiac involvement in SSc.

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Published
2019-01-16
How to Cite
1.
Javinani A, Javady Nejad Z, Gharibdoost F, Jamshidi AR, Atef Yekta R, Alvand S, Imeni V, Hashemi SN, Kavosi H. Bundle Branch Blocks and Fragmented QRS Complex in Iranian Patients with Systemic Sclerosis. J Tehran Heart Cent. 14(1):6-1.
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Original Article(s)