The electrocardiogram in systemic sclerosis ( XXXX ). Study of 102 consecutive cases with functional correlations and review of the literature.

@entity1 @entity296 @entity82 @entity714 @entity1757 @entity2631 @entity1188 @entity299 @entity67
The electrocardiographic findings in 102 consecutive @entity1 with @entity2631 were reviewed to determine the frequency and nature of the electrocardiographic abnormalities associated with this disease. @entity1188 pattern unassociated with QRS prolongation was present in 10 percent, compared with none of 96 control subjects (p less than 0.001). @entity1757 were present in 17 percent. A normal electrocardiogram was obtained in 49 percent. A subset of 48 @entity1 underwent detailed cardiopulmonary evaluation including exercise thallium scintigraphy, rest and exercise radionuclide ventriculography, pulmonary function tests, and chest roentgenography. Functional correlations of the electrocardiographic findings were examined in this subset. @entity1188 pattern (five of 48) and @entity1757 (10 of 48) were both associated with septal or anteroseptal thallium perfusion abnormalities (10 of 15 versus six of 33 of the remainder, p less than 0.005), which were present despite normal coronary angiographic results. Thallium defect scores were greater in @entity1 with @entity1188 pattern or @entity1757 compared with the remainder (defect scores 3.0 +/- 2.6 versus 1.4 +/- 2.2, respectively, p less than 0.025). In @entity1 with @entity1757 , both @entity714 and @entity714 with @entity714 were associated with abnormal left ventricular function, whereas isolated @entity714 or @entity714 was associated with normal left ventricular function. A normal electrocardiographic finding (19 of 48) was associated with normal left ventricular function at rest (19 of 19). However, 11 of 19 (58 percent) had thallium perfusion defects and four of 19 (21 percent) had an abnormal response to exercise, although in none was the peak ejection fraction less than 50 percent. It is concluded that both @entity1188 pattern and @entity1757 are electrocardiographic abnormalities associated with @entity299 ; they appear to be a result of @entity296 . Some degree of @entity296 may be present with a normal electrocardiographic result, but significant left @entity67 is unlikely. @entity1188 pattern and @entity1757 , when present, are indicators of more advanced @entity82 .
