Clinical Electrophysiology -> SVT/AVNRT/WPW/AT: -> Epidemiology of Cardiac Arrhythmias/ Epidemiology D-PO04 - Poster Session IV (ID 15) Poster

D-PO04-243 - Global Longitudinal Strain As A Predictor Of Arrhythmic Events In Systemic Sclerosis (ID 1250)

Disclosure
 G. Stronati: Nothing relevant to disclose.

Abstract

Background: Systemic sclerosis (SSc) is a rare, autoimmune disease affecting the skin and other internal organs. Cardiac involvement in SSc is frequent, mostly subclinical and represents a negative prognostic factor. Primary heart involvement in SSc has been described via speckle tracking derived measurement global longitudinal strain (GLS). Such a form SSc-related cardiomyopathy has been proven to progress over time and may be related to arrhythmias. In fact, cardiac arrhythmias represent 6% of the overall causes of death in SSc patients.
Objective: The aim of our study was to correlate the progression of GLS in SSc patients and the presence of arrhythmias.
Methods: Prospective longitudinal study enrolling all consecutive patients with a diagnosis of SSc and no overt cardiac disease nor pulmonary hypertension between February 2016 and December 2018. An echocardiographic examination and calculation of GLS were obtained at baseline and follow-up. Presence of atrial fibrillation (AF), atrial tachycardia (AT), ventricular ectopic beats >1000/24 h (VEB), bundle branch block (BBB) and atrioventricular block (AVB) was assessed through clinical history and ECG and 24-Holter monitoring over time.
Results: Over a mean follow-up period of 20 months (1st-3rd quartile, 12-24 months) 72 patients were enrolled. Among patients with SSc, 24.1% had at least one episode of AF or AT and 37.9% had a significant amount of VEB at Holter monitoring. Conduction defects were common, with 10.3% of all patients with grade I AVB, 3.4% with grade II AVB and 3.4% with complete heart block. Complete right BBB was seen in 10.3% of patients. Four patients (5.5%) died suddenly during follow-up. Worsening of GLS of both ventricles was not able to predict AF/AT episodes or VEB, but right ventricle GLS declining was more pronounced in patients who developed any grade of AVB (5.2+/-2.8 vs. 0.3+/-0.1, p=.061). Patients who died suddenly experienced a larger worsening in left ventricle GLS values (4.0+/-1.6 vs. 0.9+/-0.4, p=.056).
Conclusion: Both brady- and tachyarrhythmias are common features in SSc patients. GLS worsening over time could predict the risk of conduction defects and sudden cardiac death in patients with SSc.
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