Electrocardiographic Findings in Psoriatic Arthritis: A Case-Controlled Study

2008 ◽  
Vol 35 (12) ◽  
pp. 2379-2382 ◽  
Author(s):  
JOY FELD ◽  
GIORA WEISS ◽  
ITZHAK ROSNER ◽  
MICHAEL ROZENBAUM ◽  
ARIE LAOR ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Atrioventricular Node ◽  
Cardiac Conduction ◽  
Controlled Study ◽  
Antiinflammatory Drugs ◽  
Conduction Disturbances ◽  
Pr Interval ◽  
Electrocardiographic Findings ◽  
Electrocardiogram Ecg ◽  
Ventricular Conduction

ObjectiveWe assessed cardiac conduction properties in patients with psoriatic arthritis (PsA).MethodsElectrocardiogram (ECG) scans of 92 patients with PsA were compared to 92 age and sex matched nonpsoriatic, nonarthritic patients from general practice serving as controls.ResultsPR interval was found to be significantly longer in the PsA group compared to controls, 159.6 ± 21 ms versus 151.3 ± 26 ms, respectively (p = 0.021). No statistical difference was found with respect to the QRS interval or other atrial or ventricular conduction disturbances studied. No correlation was found between the PR interval and disease duration or PsA subtype. The use of non-steroidal antiinflammatory drugs did not affect the PR interval. Methotrexate was not found to influence the PR interval, compared to other disease modifying antirheumatic drugs. Two PsA patients (2.1%) had a PR interval > 0.2 ms. Their prolonged PR interval could not be explained by medication use. The abnormal prolongation of the PR interval was asymptomatic, requiring no additional intervention. No patient had complete heart block.ConclusionOur study may suggest subtle involvement of the atrioventricular node in patients with PsA.

scholarly journals New Insights into the Development and Morphogenesis of the Cardiac Purkinje Fiber Network: Linking Architecture and Function

2021 ◽  
Vol 8 (8) ◽  
pp. 95
Author(s):  
Caroline Choquet ◽  
Lucie Boulgakoff ◽  
Robert G. Kelly ◽  
Lucile Miquerol
Keyword(s):  
Cardiac Conduction ◽  
Purkinje Fiber ◽  
Primary Ring ◽  
Fiber Network ◽  
Conduction Disturbances ◽  
Function Relationship ◽  
And Function ◽  
Cardiac Transcription Factors ◽  
Ventricular Conduction ◽  
Ventricular Trabeculae

The rapid propagation of electrical activity through the ventricular conduction system (VCS) controls spatiotemporal contraction of the ventricles. Cardiac conduction defects or arrhythmias in humans are often associated with mutations in key cardiac transcription factors that have been shown to play important roles in VCS morphogenesis in mice. Understanding of the mechanisms of VCS development is thus crucial to decipher the etiology of conduction disturbances in adults. During embryogenesis, the VCS, consisting of the His bundle, bundle branches, and the distal Purkinje network, originates from two independent progenitor populations in the primary ring and the ventricular trabeculae. Differentiation into fast-conducting cardiomyocytes occurs progressively as ventricles develop to form a unique electrical pathway at late fetal stages. The objectives of this review are to highlight the structure–function relationship between VCS morphogenesis and conduction defects and to discuss recent data on the origin and development of the VCS with a focus on the distal Purkinje fiber network.

Prevalence of abnormalities in electrocardiogram conduction in dialysis patients: a comparative study

2020 ◽  
Author(s):  
Firas Ajam ◽  
Arda Akoluk ◽  
Anas Alrefaee ◽  
Natasha Campbell ◽  
Avais Masud ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Cardiac Conduction ◽  
Future Research ◽  
Dialysis Patients ◽  
Bundle Branch Block ◽  
Conduction Abnormality ◽  
Ckd Stage ◽  
Stage 1 ◽  
Electrocardiogram Ecg ◽  
Ecg Abnormalities

ABSTRACT Background: The electrocardiogram (ECG) can aid in identification of chronic kidney disease (CKD) patients at high risk for cardiovascular diseases. Cohort studies describe ECG abnormalities in patients on hemodialysis (HD), but we did not find data comparing ECG abnormalities among patients with normal kidney function or peritoneal dialysis (PD) to those on hemodialysis. We hypothesized that ECG conduction abnormalities would be more common, and cardiac conduction interval times longer, among patients on hemodialysis vs. those on peritoneal dialysis and CKD 1 or 2. Methods: Retrospective review of adult inpatients’ charts, comparing those with billing codes for “Hemodialysis” vs. inpatients without those charges, and an outpatient peritoneal dialysis cohort. Patients with CKD 3 or 4 were excluded. Results: One hundred and sixty-seven charts were reviewed. ECG conduction intervals were consistently and statistically longer among hemodialysis patients (n=88) vs. peritoneal dialysis (n=22) and CKD stage 1 and 2 (n=57): PR (175±35 vs 160±44 vs 157±22 msec) (p=0.009), QRS (115±32 vs. 111±31 vs 91±18 msec) (p=0.001), QT (411±71 vs. 403±46 vs 374±55 msec) (p=0.006), QTc (487±49 vs. 464±38 vs 452±52 msec) (p=0.0001). The only significantly different conduction abnormality was prevalence of left bundle branch block: 13.6% among HD patients, 5% in PD, and 2% in CKD 1 and 2 (p=0.03). Conclusion: To our knowledge, this is the first study to report that ECG conduction intervals are significantly longer as one progresses from CKD Stage 1 and 2, to PD, to HD. These and other data support the need for future research to utilize ECG conduction times to identify dialysis patients who could potentially benefit from proactive cardiac evaluations and risk reduction.

scholarly journals Regulation of Cardiac Conduction and Arrhythmias by Ankyrin/Spectrin-Based Macromolecular Complexes

2021 ◽  
Vol 8 (5) ◽  
pp. 48
Author(s):  
Drew Nassal ◽  
Jane Yu ◽  
Dennison Min ◽  
Cemantha Lane ◽  
Rebecca Shaheen ◽  
...  
Keyword(s):  
Ion Channels ◽  
Cardiac Disease ◽  
Conduction System ◽  
Cytoskeletal Proteins ◽  
Cardiac Conduction ◽  
Proper Function ◽  
Cardiac Conduction System ◽  
Loss Of Function ◽  
Macromolecular Complexes ◽  
Conduction Disturbances

The cardiac conduction system is an extended network of excitable tissue tasked with generation and propagation of electrical impulses to signal coordinated contraction of the heart. The fidelity of this system depends on the proper spatio-temporal regulation of ion channels in myocytes throughout the conduction system. Importantly, inherited or acquired defects in a wide class of ion channels has been linked to dysfunction at various stages of the conduction system resulting in life-threatening cardiac arrhythmia. There is growing appreciation of the role that adapter and cytoskeletal proteins play in organizing ion channel macromolecular complexes critical for proper function of the cardiac conduction system. In particular, members of the ankyrin and spectrin families have emerged as important nodes for normal expression and regulation of ion channels in myocytes throughout the conduction system. Human variants impacting ankyrin/spectrin function give rise to a broad constellation of cardiac arrhythmias. Furthermore, chronic neurohumoral and biomechanical stress promotes ankyrin/spectrin loss of function that likely contributes to conduction disturbances in the setting of acquired cardiac disease. Collectively, this review seeks to bring attention to the significance of these cytoskeletal players and emphasize the potential therapeutic role they represent in a myriad of cardiac disease states.

scholarly journals Identification of the Clinical Features Distinguishing Psoriatic Arthritis and Fibromyalgia

2012 ◽  
Vol 39 (4) ◽  
pp. 849-855 ◽  
Author(s):  
ANTONIO MARCHESONI ◽  
FABIOLA ATZENI ◽  
ANTONIO SPADARO ◽  
ENNIO LUBRANO ◽  
GIUSEPPE PROVENZANO ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Clinical Features ◽  
Disease Duration ◽  
Univariate Analysis ◽  
Laboratory Data ◽  
Fibromyalgia Impact Questionnaire ◽  
Somatic Symptoms ◽  
Tender Point ◽  
Antiinflammatory Drugs ◽  
Associated Symptoms

Objective.To identify the clinical features that can help to distinguish between psoriatic arthritis (PsA) and fibromyalgia (FM).Methods.Our cross-sectional study was carried out in 10 Italian rheumatology centers between January and September 2009, and enrolled all consecutive patients with PsA and FM who agreed to participate. Standard clinical and laboratory data for PsA and FM were collected from all patients. Records were made of somatic symptoms, response to nonsteroidal antiinflammatory drugs (NSAID), self-evaluated pain, general health, disability, and responses to the Fibromyalgia Impact Questionnaire. Data were statistically analyzed by univariate and multivariate analyses, and receiver-operating characteristic curves. The analysis concentrated on the clinical features shared by the 2 conditions.Results.Two hundred sixty-six patients with PsA (mean age 51.7 yrs; disease duration 10.2 yrs) and 120 patients with FM (mean age 50.2 yrs; disease duration 5.6 yrs) were evaluated. Univariate analysis showed that patients with FM had higher mean tender point and enthesitis scores, more somatic symptoms, and responded less to NSAID. Multivariate analysis showed that the presence of ≥ 6 FM-associated symptoms and ≥ 8 tender points was the best predictor of FM.Conclusion.The shared clinical features of PsA and FM that had the greatest discriminating power for FM were the number of FM-associated symptoms and tender point count.

scholarly journals Prevalence and Prognostic Relevance of Ventricular Conduction Disturbances in Patients With Aortic Stenosis

2017 ◽  
Vol 120 (12) ◽  
pp. 2226-2232 ◽  
Author(s):  
Edgard A. Prihadi ◽  
Melissa Leung ◽  
E. Mara Vollema ◽  
Arnold C.T. Ng ◽  
Nina Ajmone Marsan ◽  
...  
Keyword(s):  
Aortic Stenosis ◽  
Conduction Disturbances ◽  
Prognostic Relevance ◽  
Ventricular Conduction

scholarly journals Slow pathway ablation in patients with atrioventricular node reentrant tachycardia and a prolonged PR interval

1994 ◽  
Vol 24 (4) ◽  
pp. 1064-1068 ◽  
Author(s):  
Jasbir S. Sra ◽  
Mohammad R. Jazayeri ◽  
Zalmen Blanck ◽  
Sanjay Deshpande ◽  
Anwer A. Dhala ◽  
...  
Keyword(s):  
Atrioventricular Node ◽  
Slow Pathway ◽  
Reentrant Tachycardia ◽  
Slow Pathway Ablation ◽  
Pr Interval ◽  
Atrioventricular Node Reentrant Tachycardia

scholarly journals MyoR Modulates Cardiac Conduction by Repressing Gata4

2014 ◽  
Vol 35 (4) ◽  
pp. 649-661 ◽  
Author(s):  
John P. Harris ◽  
Minoti Bhakta ◽  
Svetlana Bezprozvannaya ◽  
Lin Wang ◽  
Christina Lubczyk ◽  
...  
Keyword(s):  
Transcriptional Repression ◽  
Atrioventricular Node ◽  
Electrical Activation ◽  
Cardiac Conduction ◽  
Specific Gene ◽  
Dependent Manner ◽  
Regulatory Circuit ◽  
Genetic Deletion ◽  
Repression Domain ◽  
Av Delay

The cardiac conduction system coordinates electrical activation through a series of interconnected structures, including the atrioventricular node (AVN), the central connection point that delays impulse propagation to optimize cardiac performance. Although recent studies have uncovered important molecular details of AVN formation, relatively little is known about the transcriptional mechanisms that regulate AV delay, the primary function of the mature AVN. We identify here MyoR as a novel transcription factor expressed in Cx30.2+cells of the AVN. We show that MyoR specifically inhibits a Cx30.2 enhancer required for AVN-specific gene expression. Furthermore, we demonstrate that MyoR interacts directly with Gata4 to mediate transcriptional repression. Our studies reveal that MyoR contains two nonequivalent repression domains. While the MyoR C-terminal repression domain inhibits transcription in a context-dependent manner, the N-terminal repression domain can function in a heterologous context to convert the Hand2 activator into a repressor. In addition, we show that genetic deletion of MyoR in mice increases Cx30.2 expression by 50% and prolongs AV delay by 13%. Taken together, we conclude that MyoR modulates a Gata4-dependent regulatory circuit that establishes proper AV delay, and these findings may have wider implications for the variability of cardiac rhythm observed in the general population.

Comprehensive Treatment of Dactylitis in Psoriatic Arthritis

2014 ◽  
Vol 41 (11) ◽  
pp. 2295-2300 ◽  
Author(s):  
Shawn Rose ◽  
Sergio Toloza ◽  
Wilson Bautista-Molano ◽  
Philip S. Helliwell
Keyword(s):  
Psoriatic Arthritis ◽  
Primary Outcome ◽  
Treatment Options ◽  
Current Treatment ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Clinical Feature ◽  
Comprehensive Treatment ◽  
Limited Data ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antiinflammatory Drugs

Dactylitis, a hallmark clinical feature of psoriatic arthritis (PsA) and other spondyloarthropathies, may also be a severity marker for PsA and psoriasis. Traditionally, clinicians have used nonsteroidal antiinflammatory drugs and local corticosteroid injections to treat dactylitis, although conventional disease-modifying antirheumatic drugs are also used. We performed a systematic literature review to determine the most efficacious current treatment options for dactylitis in PsA. Effect sizes were greatest for the biologic agents ustekinumab, certolizumab, and infliximab, suggesting that therapy with one of these agents should be initiated in patients with dactylitis. However, the limited data highlight the need for randomized, placebo-controlled trials, with dactylitis as a primary outcome, to determine a valid, reliable, and responsive clinical outcome measure for PsA patients with dactylitis.

Anomalous Atrioventricular Excitation (Wolff-Parkinson-White Syndrome)

PEDIATRICS ◽  
1959 ◽  
Vol 23 (5) ◽  
pp. 902-902
Keyword(s):  
Atrioventricular Node ◽  
Atrial Arrhythmias ◽  
White Syndrome ◽  
Pr Interval ◽  
Ventricular Activation ◽  
Excitation Pattern ◽  
Retrograde Conduction ◽  
Wolff Parkinson White Syndrome

Vectorcardiographic and electrocardiographic data in 4 patients with the Wolff-Parkinson-White syndrome are presented. These studies support the concept that the mechanism responsible for the pre-excitation pattern is a functioning accessory neuromuscular bridge that by-passes the atrioventricular node. Early delivery of the impulse from the sino-auricular node to the lower chambers initiates premature ventricular activation with consequent shortening of the PR interval and lengthening of the QRS interval. Retrograde conduction through the accessory tract may be observed, and is a possible explanation of the atrial arrhythmias that occur in this syndrome.

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