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QT and P-wave dispersions in rheumatic heart disease: Prospective long-term follow up.
[acute rheumatic fever]
Simple
electrocardiogram
(
ECG
)
markers
have
been
used
to
evaluate
conduction
times
.
Acute
rheumatic
fever
(
ARF
)
is
an
autoimmune
disease
that
affects
these
conduction
times
.
The
aim
of
this
prospective
long
-term
follow-up
study
was
to
evaluate
QT
,
QTc
and
P-
wave
dispersions
in
children
with
ARF
and
chronic
rheumatic
heart
disease
(
CRHD
)
.
Sixty
-
four
patients
with
ARF
,
33
patients
with
CRHD
and
41
healthy
,
age-
and
sex-matched
control
subjects
were
included
in
the
study
.
The
ARF
patients
were
divided
into
two
subgroups
:
carditis
and
arthritis
.
Echocardiographic
and
ECG
measurements
at
the
onset
of
diagnosis
and
final
evaluation
were
included
.
QT
,
QTc
and
P-
wave
dispersions
were
significantly
greater
in
both
the
ARF
carditis
and
CRHD
groups
than
the
ARF
arthritis
and
control
subjects
during
the
initial
and
final
analysis
(
for
all
,
P
<
0
.
001
)
.
There
was
no
significant
statistical
difference
in
QT
,
QTc
and
P-
wave
dispersion
between
the
initial
and
final
analysis
in
each
groups
.
Severity
of
mitral
regurgitation
and
left
atrial
enlargement
were
found
to
be
positively
correlated
with
P-
wave
dispersion
(
r
=
0
.
438
,
P
<
0
.
001
;
r
=
0
.
127
,
P
<
0
.
001
,
respectively
)
.
QT
,
QTc
and
P-
wave
dispersion
greater
than
52
,
60
and
57
ms
,
respectively
,
had
higher
sensitivity
and
specificity
for
predicting
ARF
carditis
.
These
ECG
measurements
can
be
used
in
the
diagnosis
of
ARF
carditis
as
minor
criteria
with
modified
Jones
criteria
.
In
contrast
,
this
increase
in
the
dispersions
is
permanent
in
patients
with
ARF
carditis
.
Diseases
Validation
Diseases presenting
"simple electrocardiogram"
symptom
acute rheumatic fever
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