Assessing QT interval in patients with autoimmune chronic inflammatory diseases: perils and pitfalls

Lazzerini, Pietro Enea; Capecchi, Pier Leopoldo; Laghi‐Pasini, Franco

doi:10.1136/lupus-2016-000189

Cited by 9 publications

(4 citation statements)

References 30 publications

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“…However, in our study, no association was found between the disease subtypes, skin scores, capillaroscopic findings, and ECG findings. When different connective tissue diseases were examined, it was reported that there was a relationship between QTD prolongation and the development of complex ventricular arrhythmias in patients with anti-SSA positivity (22). In our study, there was no significant association between cQTD and anti-SSA positivity.…”

Section: Discussioncontrasting

confidence: 64%

Increased QT dispersion and related factors in patients with systemic sclerosis

Gündüz

Alptürker

2022

Anatolian Current Medical Journal

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Introduction: Cardiac arrhythmias and sudden death may occur as a result of ventricular myocardial fibrosis or ischemia in patients with systemic sclerosis (SSc). QT prolongation and QT dispersion, which facilitate the development of ventricular fibrillation, are important cardiac problems associated with increased mortality. In this study, we aimed to investigate the prevalence of corrected QT dispersion (cQTD) and related factors in our patients with systemic sclerosis compared to healthy controls. Material and Method: The 12-lead electrocardiograms with a rate of 25 mm/s of patients with no previous history of cardiovascular disease and controls were analyzed. cQTD was defined as the difference between the maximum QT interval and the minimum QT interval. Nailfold capillaroscopy examination was performed. Disease activity was evaluated using revised European Scleroderma Study Group activity index. Results: Forty-nine SSc patients (45 females, mean age 53.26±10.63 years, and disease duration 8.0 (1-25) years) and 41 controls (37 females, mean age 49.29±8.02 years) were included. While the frequency of smoking was significantly higher in controls (p=0.025), erythrocyte sedimentation rate was higher in patients (p

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Section: Discussioncontrasting

confidence: 64%

Increased QT dispersion and related factors in patients with systemic sclerosis

Gündüz

Alptürker

2022

Anatolian Current Medical Journal

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“…Finally, as discussed in more details in the following section “Experimental Data,” anti-Ro/SSA-antibodies can concomitantly inhibit multiple cardiac ion channels, resulting in conflicting effects on APD, thereby on QT interval duration on the surface ECG ( 21 , 90 ). Such a multifaceted impact on cardiomyocyte electrophysiology, along with the inherent (genetic and acquired) variability in cardiac ion channels reserves among different individuals ( 91 , 92 ), may also significantly contribute to the reported discrepancies among clinical studies ( 21 , 90 ).…”

Section: Anti-ro/ssa-associated Long-qt Syndromementioning

confidence: 99%

Anti-Ro/SSA Antibodies and the Autoimmune Long-QT Syndrome

et al. 2021

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Autoimmunity is increasingly recognized as a novel pathogenic mechanism for cardiac arrhythmias. Several arrhythmogenic autoantibodies have been identified, cross-reacting with different types of surface proteins critically involved in the cardiomyocyte electrophysiology, primarily ion channels (autoimmune cardiac channelopathies). Specifically, some of these autoantibodies can prolong the action potential duration leading to acquired long-QT syndrome (LQTS), a condition known to increase the risk of life-threatening ventricular arrhythmias, particularly Torsades de Pointes (TdP). The most investigated form of autoimmune LQTS is associated with the presence of circulating anti-Ro/SSA-antibodies, frequently found in patients with autoimmune diseases (AD), but also in a significant proportion of apparently healthy subjects of the general population. Accumulating evidence indicates that anti-Ro/SSA-antibodies can markedly delay the ventricular repolarization via a direct inhibitory cross-reaction with the extracellular pore region of the human-ether-a-go-go-related (hERG) potassium channel, resulting in a higher propensity for anti-Ro/SSA-positive subjects to develop LQTS and ventricular arrhythmias/TdP. Recent population data demonstrate that the risk of LQTS in subjects with circulating anti-Ro/SSA antibodies is significantly increased independent of a history of overt AD, intriguingly suggesting that these autoantibodies may silently contribute to a number of cases of ventricular arrhythmias and cardiac arrest in the general population. In this review, we highlight the current knowledge in this topic providing complementary basic, clinical and population health perspectives.

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“…Among the different organs potentially affected by SLE, heart involvement may be of particular severity. In particular, QT interval prolongation, which may be promoted by both cardiomyocyte apoptosis ( 103 ) and chronic inflammation ( 104 ), is a common finding in SLE ( 105 ) and may increase the risk of cardiovascular complications ( 106 ). Since enhanced efferocytosis of apoptotic cardiomyocytes promotes inflammation resolution and cardiac repair ( 107 ), this might translate into improved electric impulse propagation as well.…”

Section: Pathologies Associated With Improper Efferocytosismentioning

confidence: 99%

The Role of Efferocytosis in Autoimmune Diseases

et al. 2018

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Apoptosis happens continuously for millions of cells along with the active removal of apoptotic debris in order to maintain tissue homeostasis. In this respect, efferocytosis, i.e., the process of dead cell clearance, is orchestrated through cell exposure of a set of “find me,” “eat me,” and “tolerate me” signals facilitating the engulfment of dying cells through phagocytosis by macrophages and dendritic cells. The clearance of dead cells via phagocytes is of utmost importance to maintain the immune system tolerance to self-antigens. Accordingly, this biological activity prevents the release of autoantigens by dead cells, thus potentially suppressing the undesirable autoreactivity of immune cells and the appearance of inflammatory autoimmune disorders as systemic lupus erythematous and rheumatoid arthritis. In the present study, the apoptosis pathways and their immune regulation were reviewed. Moreover, efferocytosis process and its impairment in association with some autoimmune diseases were discussed.

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Assessing QT interval in patients with autoimmune chronic inflammatory diseases: perils and pitfalls

Cited by 9 publications

References 30 publications

Increased QT dispersion and related factors in patients with systemic sclerosis

Increased QT dispersion and related factors in patients with systemic sclerosis

Anti-Ro/SSA Antibodies and the Autoimmune Long-QT Syndrome

The Role of Efferocytosis in Autoimmune Diseases

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