Key result
In patients newly diagnosed with systemic lupus erythematosus, the presence of a fragmented QRS complex on electrocardiogram was significantly associated with higher disease activity (adjusted regression coefficient 2.69).
Why the study?
Cardiovascular disease contributes significantly to mortality in systemic lupus erythematosus and relates to disease activity, but the relationship between disease activity and fragmented QRS at diagnosis needed assessment.
Is the presence of fragmented QRS associated with higher disease activity in patients with newly diagnosed systemic lupus erythematosus?
Cross-Sectional (n=44)
Blinded ECG evaluation
Yes
Is the presence of fragmented QRS associated with higher disease activity in patients with newly diagnosed systemic lupus erythematosus?
The presence of fragmented QRS on ECG is associated with higher disease activity in newly diagnosed SLE patients, potentially indicating subclinical myocardial involvement.
Answers are grounded in this paper and cite their sources.
fQRS may mark higher SLE activity at diagnosis; leaves open its value for cardiac risk prediction.
OBJECTIVE: Cardiovascular disease is an important contributor to the mortality rate of patients with systemic lupus erythematosus (SLE), which is related to SLE disease activity. Fragmented QRS (fQRS) complexes, defined by additional spikes in the QRS complex, are useful for identifying myocardial scars on electrocardiography and can be an independent predictor of cardiac events. We aimed to assess the relationship between disease activity in patients with SLE and fQRS at the time of diagnosis. METHODS: Forty-four patients with SLE were included. Patients with cardiac diseases, other rheumatic diseases, and prior treatment at the time of electrocardiography measurement were excluded. The appearance of fQRS represented exposure. The primary outcome was SLE Disease Activity Index 2000 (SLEDAI-2K). Multiple regression analysis was conducted to assess the association between fQRS and SLEDAI-2K adjusted for age, sex, and time from the estimated onset date to the date of diagnosis. RESULTS: Among patients with SLE at diagnosis, 26 (59.1%) had fQRS. The median SLEDAI-2K was 18 (interquartile range [IQR], 12-22) and 9 (IQR, 8-15) in the fQRS(+) and fQRS(-) groups, respectively. SLEDAI-2K was significantly higher in the fQRS(+) group than in the fQRS(-) group (regression coefficient, 2.69; 95% confidence interval, 0.76-4.61; p = 0.008). CONCLUSION: Our results suggested that fQRS(+) patients with SLE had high disease activity. fQRS could likely detect subclinical myocardial involvement in patients with SLE and predict long-term occurrence of cardiac events.
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Hosonuma et al. (2020) conducted a cross-sectional in Systemic lupus erythematosus (n=44). Fragmented QRS (fQRS) complex vs. Absence of fQRS was evaluated on SLE Disease Activity Index 2000 (SLEDAI-2K) (Regression coefficient 2.69, 95% CI 0.76-4.61, p=0.008). In patients newly diagnosed with systemic lupus erythematosus, the presence of a fragmented QRS complex on electrocardiogram was significantly associated with higher disease activity (adjusted regression coefficient 2.69).
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