Electrocardiographic Changes in Rheumatoid Arthritis

Abstract

To evaluate the significance of heart changes in rheumatoid arthritis, ST-T changes of electrocardiogram in healthy control were studied. It was significantly less frequently observed in the control group than in rheumatoid patient group. HIS report deals with the incidence of electrocardiographic abnormalities in the control group as compared with previously reported incidence of heart changes in rheumatoid patients.1),2) Following results had been confirmed by the author: Among 158 patients with rheumatoid arthritis, depression of ST segment and/or inverted or flat T wave were proved in 20.9 per cent (33 patients), prolonged QT ratio in 7.6, first degree A-V block in 1.3, premature beats (ventricular or supra-ventricular) in 3.8, complete right bundle branch block in 0.6, auricular fibrillation in 0.6, sinus tachycardia in 3.2, and sinus bradycardia in 2.5. Age factors of the disease were not related to the incidence of electrocardiographical abnormalities.ST segment and/or T wave changes were more frequently found in the patients with high serum beta and/or gamma globulin. There were 6 autopsied cases of rheumatoid arthritis. All of them showed anatomical heart lesions. MATERIALS AND METHODSSex and age distributions of 158 patients with rheumatoid arthritis were described elsewhere.1),2) The definition and classification of rheumatoid arthritis followed Steinbrocker and Ropes' criteria.3),4) The control group consisted of 182 healthy persons, 129 males and 53 females, whose ages ranged from 17 to 66 years. One hundred and one were apparently healthy employees of a department store in Tokyo. The blood pressure was not over 150 100 in all of them. Eighty-one were healthy volunteers including physicians, nurses and others. Among them, 102 were over 50 years of age. The average age was 41.64. The control group is not ideally matched for their sex and age distribution to the group of rheumatoid arthritis. But as shown in Table I, age distribution in rheumatoid arthritis and the control group had no significant discrepancy. X2=5.07<x32(0.05)=7.81 Twelve

Cardiac function abnormalities in rheumatoid arthritis and its association with duration of disease: a hospital-based case control study

“…29 Masooleh et al and Asai K et al found 15% and 20.9% had ST changes respectively. 25,30 Second most common finding in our study was right bundle branch block (7.1%) which was comparable to findings of other studies. 25,29,30 Sinus bradycardia was not found in any patient as was similarly reported by other studies.…”

“…25,30 Second most common finding in our study was right bundle branch block (7.1%) which was comparable to findings of other studies. 25,29,30 Sinus bradycardia was not found in any patient as was similarly reported by other studies. 25,29 Most common echocardiographic abnormality was LV diastolic dysfunction found in 42.2% cases of rheumatoid arthritis as compared to only 4.3% among controls.…”

“…Various past studies also reported normal ECG in most RA patients. 29,30 Most common ECG abnormality was non-specific ST-T changes present in 12.4% cases which was comparable to findings of Raminderpal Singh et al in which 8.33% cases had ST-T changes. 29 Masooleh et al and Asai K et al found 15% and 20.9% had ST changes respectively.…”

Το Ηλεκτροκαρδιογραφημα Επι Ρευματοειδους Αρθριτιδος

“…"Συχνότερα τών υποκειμενικών συμπτωμάτων εΐναι ή άνεύρεσις αντικει μενικών κλινικών ή εργαστηριακών σημείων καρδιοπάθειας, τα οποία δυνατόν να υπάρχουν πολύ ένωρίτερον. Ούτω παθολογικοί καρδιακοί τόνοι και φυσή ματα παρατηρούνται εις σχετικώς ύψηλόν ποσοστόν (20% περίπου) 5 .…”

“…Αί μεγαλύτεραι σειραί παθολογοανατομικώς μελετηθέντων ασθενών μέ ρευματοειδή αρθρίτιδα, οΐτινες ένεφάνισαν αλλοιώσεις εκ τής καρδίας είς ύ-ψηλήν σχετικώς συχνότητα, έδημοσιεύθησαν υπό τών ßaggenstos και Rosenberg (1941), Young και Schwedel (1944), Bywaters (1950), Cruickshank (1958), Lebowitz (1963), Sokoloff (1964) 134 • Ή διαφορά αΰτη πιθανώς οφείλεται αφ' ενός μεν είς την ελλειψιν ειδι κών κλινικών ευρημάτων εκ της καρδίας χαρακτηριστικών της ρευματοειδούς άρθρίτιδος, άφ' ετέρου δε είς την υπό πολλών Ιατρών άπόδοσιν τών διαπιστου μένων καρδιακών εκδηλώσεων είς αλλάς αιτίας. 5 Εξ άλλου ή μακρά κατάκλισις τών ασθενών αυτών ώς και ή χρονία λήψις αναλγητικών καί άντιφλεγμονωδών φαρμάκοον εμποδίζουν την έκδήλωσιν πλείστων καρδιακών συμπτωμάτων !32 . Συχνότερον προσβάλλεται ή καρδία επί τών βαρύτερων μορφών της νό σου μετά θετικής αής όροαντιδράσεως δια τον ρευματοειδή παράγοντα, επί πυλυαρθρι.κής ή επί μονοαρθρικής εντοπίσεως ταύτης, επί υπάρξεως υποδορίων οζιδίων καί επισκληρίτιδος ή οσάκις υφίσταται καί ετέρα σπλαγχνική εντόπισις ρευματοειδούς φύσεως 20, 32, 51> 74, 129 .…”