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Ventricular Late Potentials in Systemic Sclerosis: Relationship with Skin Involvement
MICHELE PARADISO, MANUELA DI FRANCO, ANTONINO MUSCA, STEFANIA BASILI, VALERIA RICCIERI, VINCENZO PAOLETTI, ANTONIO DE MATTEIS, and ANTONIO MAMMARELLA
ABSTRACT. Methods. We selected 24 SSc outpatients according to American Rheumatism Association criteria, without clinical and instrumental evidence of cardiac disease, and compared them with 24 control subjects. All patients and controls underwent SA-ECG to detect ventricular late potentials (LP). The extent and severity of skin involvement in SSc patients was detected by modified Rodnan (m-Rodnan) skin score. Results. SSc patients had higher prevalence of LP compared to controls (46 versus 8%, p < 0.003). Median skin score value in the overall SSc population was 7 [mean, SD (range): 7.8, 3.2, (4-18)]. Patients with LP had a higher median skin score value compared to SSc patients without LP [median (range): 10 (6-18) versus 6 (4-9); Mann-Whitney U test 22.5, p < 0.005]. A subset analysis was also performed to verify the correlation of antibodies positivity (anti-centromere and Scl 70) pattern and the presence of LP. Our findings showed that higher values of skin score correlated with the presence of LP independent of antibody subsets. Conclusions. Our data suggest that diffuse abnormalities of the cardiac tissue detected by SA-ECG may be present, even in patients without cardiac symptoms. The relationship between LP and skin involvement in patients without clinical evidence of cardiac involvement may help detect of a subset of patients who may develop scleroderma heart disease. (J Rheumatol 2002;29:1388-92) Key Indexing Terms:
SYSTEMIC SCLEROSIS
From the Department of Medical Therapy and the Rheumatology Unit, University "La Sapienza," Rome, Italy. M. Paradiso, MD, Department of Medical Therapy; M. Di Franco, Researcher, Rheumatology Unit; A. Musca, Professor of Internal Medicine; S. Basili, Researcher in Internal Medicine, Department of Medical Therapy; V. Riccieri, Researcher in Rheumatology, Rheumatology Unit; V. Paoletti, Researcher in Internal Medicine; A. De Matteis, MD; A. Mammarella, Researcher in Internal Medicine, Department of Medical Therapy. Address reprint requests to Dr. M. Paradiso, Viale dei Primati Sportivi, 54, I-00144, Roma, Italy. E-mail: michele.paradiso@uniroma1.it Submitted May 8, 2001; revision accepted November 18, 2001. |