Drs. Galeazzi, Marcolongo, and Laghi-Pasini contributed equally to this work.
Prolongation of the corrected QT interval in adult patients with anti-Ro/SSA–positive connective tissue diseases
Article first published online: 5 APR 2004
Copyright © 2004 by the American College of Rheumatology
Arthritis & Rheumatism
Volume 50, Issue 4, pages 1248–1252, April 2004
How to Cite
Lazzerini, P. E., Acampa, M., Guideri, F., Capecchi, P. L., Campanella, V., Morozzi, G., Galeazzi, M., Marcolongo, R. and Laghi-Pasini, F. (2004), Prolongation of the corrected QT interval in adult patients with anti-Ro/SSA–positive connective tissue diseases. Arthritis & Rheumatism, 50: 1248–1252. doi: 10.1002/art.20130
- Issue published online: 5 APR 2004
- Article first published online: 5 APR 2004
- Manuscript Accepted: 17 DEC 2003
- Manuscript Received: 8 AUG 2003
Newborns of mothers positive for anti-Ro/SSA autoantibodies may develop a series of electrocardiographic (EKG) disturbances. Prolongation of the corrected QT (QTc) interval was recently reported in a significant proportion of children with maternally acquired anti-Ro/SSA antibodies, with a concomitant disappearance of EKG abnormalities and acquired maternal autoantibodies during the first year, suggesting a direct, reversible electrophysiologic effect of anti-Ro/SSA antibodies on the ventricular repolarization. On this basis, we investigated whether these antibodies may also affect cardiac repolarization in anti-Ro/SSA–positive adult patients with connective tissue diseases.
Fifty-seven patients with connective tissue diseases were selected: 31 had anti-Ro/SSA antibodies and 26 did not (controls). In all subjects, we analyzed the QTc interval, heart rate variability, and signal-averaged high-resolution EKG recording.
Anti-Ro/SSA–positive patients showed a significant prolongation of the mean QTc interval compared with the controls (mean ± SD 445 ± 21 versus 419 ± 17 msec; P = 0.000005). Eighteen of the 31 anti-Ro/SSA–positive patients (58%) and none of the 26 anti-Ro/SSA–negative patients had QTc values above the upper limit of normal (440 msec). Both groups had a reduction in heart rate variability, with a prevalence for the sympathetic nervous system and a high incidence of ventricular late potentials; these values were not significantly different between the 2 groups.
Adult patients with anti-Ro/SSA–positive connective tissue diseases showed a high prevalence of QTc interval prolongation. This feature, with the concomitant abnormalities in the autonomic tone and ventricular late excitability observed in all patients studied, suggests that anti-Ro/SSA–positive patients may have a particularly high risk of developing life-threatening arrhythmias.