RELATIONSHIPS BETWEEN ELECTROCARDIOGRAPHIC AND ECHOCARDIOGRAPHIC FINDINGS IN SYSTEMIC-SCLEROSIS (SCLERODERMA)

We assessed the prevalence of electrocardiographic abnormalities in pa tients with systemic sclerosis and evaluated their functional signific ance through a comparison with echocardiographic findings. Seventy-two patients with systemic sclerosis and 64 controls underwent resting el ectrocardiogram (EGG) and hi-mode, two-dimensional, Doppler and color Doppler echocardiography. Electrocardiographic abnormalities were obse rved in 48.7% of patients. Conduction disturbances (27.7%), infarction pattern (13.8%), non-specific ST-T wave changes (13.8%) and right ven tricular hypertrophy (11.1%) were the most frequent abnormalities. QTc interval was significantly longer in patients with systemic sclerosis than in controls. Significant differences between patients and contro ls were found in the prevalence of long QTc interval (p=0.0016), infar ction pattern (p=0.0016), right ventricular hypertrophy (p=0.007) and non-specific ST-T wave abnormalities (p=0.0016). All patients with inf arction pattern and 90% of patients with prolonged QTc interval had so me echocardiographic abnormalities. Electrocardiographic signs of righ t ventricular hypertrophy were 16% sensitive and 93% specific for pulm onary hypertension; the sensitivity and specificity of the combination of right ventricular hypertrophy, right atrial enlargement and right bundle branch block were 35% and 90%, respectively. Standard ECG is us eful to assess cardiac involvement in patients with systemic sclerosis . If infarction pattern, right ventricular hypertrophy or long QTc int erval are present, a cardiac involvement is very likely.