RESEARCH - Connective tissue diseases and cardiac rhythm disorders

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Autoimmun Rev. 2006 May;5(5):306-13. Epub 2005 Dec 9.

Connective tissue diseases and cardiac rhythm disorders: an overview.

Lazzerini PE, Capecchi PL, Guideri F, Acampa M, Galeazzi M, Laghi Pasini F.

Department of Clinical Medicine and Immunological Sciences, Division

of Clinical Immunology, University of Siena, Viale Bracci, 53100

Siena, Italy.

Cardiovascular involvement is common in connective tissue diseases

(CTD), with relevant implications in terms of morbidity and mortality.

Rhythm disturbances, i.e. conduction defects and tachyarrhythmias,

represent a frequent clinical manifestation of CTD-associated

cardiovascular damage and a possible cause of sudden death. The

underlying arrhythmogenic mechanisms are probably multiple and

intriguing, even though the myocardial fibrosis frequently observed at

the pathological examination seems to play a pivotal role. Myocardial

fibrosis is produced directly by inflammatory processes, or indirectly

as a consequence of coronary artery occlusive disease, and it may

affect the conduction system also representing the pathological

substrate for reentry circles. An overview of CTD-associated cardiac

rhythm disturbances is here provided. Among CTD-associated rhythm

disorders, congenital heart block (CHB), which represents the main

feature of neonatal lupus, a rare syndrome related to the

transplacental passage of autoantibodies from anti-Ro/SSA-positive

mother to their newborns, seems to acknowledge a peculiar mechanism of

disease possibly dependent on a direct arrhythmogenicity of

anti-Ro/SSA antibodies. Moreover, new anti-Ro/SSA-associated EKG

abnormalities have been recently described in children (sinus

bradycardia and corrected QT (QTc) interval prolongation) as well as

in adults (QTc interval prolongation).

PMID: 16782554

http://www.ncbi.nlm.nih.gov/pubmed/16782554

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