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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
"autoimmune disease"
symptom
acute rheumatic fever
coats disease
familial hypocalciuric hypercalcemia
familial mediterranean fever
harlequin ichthyosis
inclusion body myositis
kabuki syndrome
malignant atrophic papulosis
omenn syndrome
sneddon syndrome
waldenström macroglobulinemia
wiskott-aldrich syndrome
This symptom has already been validated