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Prolonged Tpeak–Tend interval in anti-Ro52 antibody-positive connective tissue diseases

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Abstract

Patients with connective tissue diseases (CTDs) may have prolonged corrected QT interval which indicates increased risk for ventricular arrhythmias. However, a more sensitive measure of ventricular repolarization, T-peak-to-end (Tpe) interval, has not been studied in CTDs. We aimed to investigate the relationship between ventricular repolarization abnormalities and anti-Ro52-positivity in subjects with connective tissue diseases (CTDs). We enrolled patients with anti-Ro52-positive CTDs, ANA-positive CTDs, and healthy subjects in this cross-sectional study. We excluded conditions potentially affecting the QT interval. We compared the ECG measures between the groups and performed analyses to define factors associated with ventricular repolarization measures. 15 ANA and anti-Ro52-positive, 39 ANA-positive and anti-Ro52-negative, and 22 healthy subjects were enrolled. None of the subjects had rhythm or conduction disturbances. Corrected QT intervals were similar between the groups. Tpe (84, 77.3, and 69.4 msn, respectively) and QT-dispersion (40, 27.2, and 20.1 msn, respectively) were higher in anti-Ro52-positive subjects compared with the ANA-positive and healthy subjects. Anti-Ro52 titers were correlated with Tpe and QT-dispersion (r = 0.52 and p < 0.001 for each). ANA and anti-Ro52-positivity were independently associated with higher Tpe (OR = 7.7, p = 0.001 and OR = 6.9, p = 0.001, respectively), corrected Tpe (OR = 11.3, p = 0.001 and OR = 8.4, p = 0.003, respectively), QT dispersion (OR = 7, p = 0.008 and OR = 13, p < 0.001, respectively), and QTc dispersion (OR = 9.1, p = 0.001 and OR = 14.1, p < 0.001, respectively). This study provides evidence that ANA positivity, especially when concomitant anti-Ro52-positivity is present, significantly deteriorates ventricular repolarization. The aforementioned ventricular repolarization abnormalities may render these subjects susceptible to serious rhythm or conduction disorders in the setting of predisposing conditions.

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Acknowledgments

We thank Ercan Cegilli, MD (Department of Cardiology, Uludag University School of Medicine) for his help in measurement of ECG data.

Funding

We thank Bursa Kidney Foundation for their funding support.

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Authors and Affiliations

  1. Department of Rheumatology, Uludag University School of Medicine, Gorukle, Bursa, Turkey

    Ayse Nur Tufan, Mustafa Ferhat Oksuz, Selime Ermurat, Belkis Nihan Coskun, Yavuz Pehlivan & Ediz Dalkilic

  2. Department of Cardiology, Uludag University School of Medicine, Gorukle, Bursa, Turkey

    Saim Sag & Ibrahim Baran

  3. Department of Nephrology, Uludag University School of Medicine, Gorukle, Bursa, Turkey

    Mustafa Gullulu

  4. Department of Immunology, Uludag University School of Medicine, Gorukle, Bursa, Turkey

    Ferah Budak

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  1. Ayse Nur Tufan
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Correspondence to Ayse Nur Tufan or Saim Sag.

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The ethical committee of Uludag University School of Medicine approved the study, and we carried out the study in accordance with the Declaration of Helsinki and its later amendments.

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Tufan, A.N., Sag, S., Oksuz, M.F. et al. Prolonged Tpeak–Tend interval in anti-Ro52 antibody-positive connective tissue diseases. Rheumatol Int 37, 67–73 (2017). https://doi.org/10.1007/s00296-016-3488-1

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