Fragmented QRS complex in patients with systemic lupus erythematosus at the time of diagnosis and its relationship with disease activity.

<h4>Objective</h4>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 ident...

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Main Authors: Masahiro Hosonuma, Nobuyuki Yajima, Ryo Takahashi, Ryo Yanai, Taka-Aki Matsuyama, Eiji Toyosaki, Jumpei Saito, Kengo Kusano, Hiroshi Morita
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2020-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0227022&type=printable
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author Masahiro Hosonuma
Nobuyuki Yajima
Ryo Takahashi
Ryo Yanai
Taka-Aki Matsuyama
Eiji Toyosaki
Jumpei Saito
Kengo Kusano
Hiroshi Morita
author_facet Masahiro Hosonuma
Nobuyuki Yajima
Ryo Takahashi
Ryo Yanai
Taka-Aki Matsuyama
Eiji Toyosaki
Jumpei Saito
Kengo Kusano
Hiroshi Morita
author_sort Masahiro Hosonuma
collection DOAJ
description <h4>Objective</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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).<h4>Conclusion</h4>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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spelling doaj-art-01552379dc2b46f5a94778fc94d277bc2025-08-20T02:55:12ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01151e022702210.1371/journal.pone.0227022Fragmented QRS complex in patients with systemic lupus erythematosus at the time of diagnosis and its relationship with disease activity.Masahiro HosonumaNobuyuki YajimaRyo TakahashiRyo YanaiTaka-Aki MatsuyamaEiji ToyosakiJumpei SaitoKengo KusanoHiroshi Morita<h4>Objective</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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).<h4>Conclusion</h4>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.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0227022&type=printable
spellingShingle Masahiro Hosonuma
Nobuyuki Yajima
Ryo Takahashi
Ryo Yanai
Taka-Aki Matsuyama
Eiji Toyosaki
Jumpei Saito
Kengo Kusano
Hiroshi Morita
Fragmented QRS complex in patients with systemic lupus erythematosus at the time of diagnosis and its relationship with disease activity.
PLoS ONE
title Fragmented QRS complex in patients with systemic lupus erythematosus at the time of diagnosis and its relationship with disease activity.
title_full Fragmented QRS complex in patients with systemic lupus erythematosus at the time of diagnosis and its relationship with disease activity.
title_fullStr Fragmented QRS complex in patients with systemic lupus erythematosus at the time of diagnosis and its relationship with disease activity.
title_full_unstemmed Fragmented QRS complex in patients with systemic lupus erythematosus at the time of diagnosis and its relationship with disease activity.
title_short Fragmented QRS complex in patients with systemic lupus erythematosus at the time of diagnosis and its relationship with disease activity.
title_sort fragmented qrs complex in patients with systemic lupus erythematosus at the time of diagnosis and its relationship with disease activity
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0227022&type=printable
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