{
  "abstract": "Introduction Cardiac involvement is a major cause of death in systemic sclerosis (SSc). According to EUSTAR registries, it accounts for up to 26% of mortality, with arrhythmias and conduction disturbances responsible for about 6% of all-cause deaths. Due to limited data on resting ECG abnormalities in SSc, we aimed to assess their prevalence and clinical correlates in a real-world cohort.Material and Methods We included 50 patients with SSc followed in our rheumatology clinic between 2006 and 2025. Demographic, clinical, and laboratory data were retrospectively collected from medical records. The last available standard 12-lead ECG was analysed according to current guidelines. Transthoracic echocardiography was available in 40 patients (80%). Variables were first compared between groups using appropriate statistical tests. Those with p < 0.20 were further explored in univariate binary logistic regression models to estimate odds ratios (OR) and 95% confidence intervals.Results The median follow-up was 8.1 years (IQR 4.8–11.5). The median age was 63 years (IQR 49.5–78.3) and 92% (n=46) were female. The limited cutaneous subtype was the most frequent [80% (n=40)], followed by diffuse cutaneous (6%), VEDOSS (10%) and sine scleroderma (4%). Median disease duration was 10.3 years (IQR 6.7–15.4). Interstitial lung disease was present in 16% (n=8) and pulmonary arterial hypertension in 10% (n=5). Mortality during follow-up was 6% (n=3), all occurring in patients with abnormal ECG. Resting ECG abnormalities were identified in 68% (n=34). Conduction disturbances were the most common findings, including left anterior fascicular block [28% (n=14)], left posterior fascicular block [12% (n=6)], right and left bundle branch block [4% (n=2) and 2% (n=1)], and first-degree atrioventricular block [4% (n=2)]. Intraventricular conduction delay occurred in 16% (n=8) and non-specific repolarization changes in 32% (n=16). Arrhythmias were observed in 10% (n=5), mainly sinus tachycardia (6%) and atrial fibrillation/flutter (4%). In univariate binary logistic regression, ECG abnormalities were associated with valvular disease on echocardiogram (OR 2.90; p=0.040), while dysphagia appeared less frequent in patients with abnormal ECG (25% vs 3%; OR 0.09; p=0.046). Non-significant trends suggested that patients with abnormal ECG were older, had longer disease duration and greater diagnostic delay ( table 1).Conclusions ECG abnormalities were frequent in this SSc cohort, with conduction disturbances representing the most prevalent findings. Both valvular disease and dysphagia were independently associated with ECG abnormalities, the latter showing an apparently protective effect. Baseline and follow-up ECG assessments should be prioritised in routine rheumatology consultations to enable early detection and management of cardiac involvement.Abstract P.147 Table 1Clinical, laboratory and echocardiographic characteristics of SSc patients according to ECG findings. Values are presented as n (%) or median (IQR). p-values are from group comparisons; variables with p < 0.20 were further analysed using univariate binary logistic regression (OR, 95% CI). Abbreviations: ACA, anticentromere antibodies; Anti-M2, anti-mitochondrial antibody M2; Anti-RNP3, anti-ribonucleoprotein P3; Anti-SSa, anti-Ro/SS-A; Anti-Tho, anti-Th/To; Anti-U1-RNP, anti-U1 ribonucleoprotein; BMI, body mass index; CI, confidence interval; CRP, C-reactive protein; ECG, electrocardiogram; EF, ejection fraction; ESR, erythrocyte sedimentation rate; GERD, gastroesophageal reflux disease; ILD, interstitial lung disease; IQR, interquartile range; LA, left atrium; NT-proBNP, N-terminal pro-brain natriuretic peptide; OR, odds ratio; PSAP, pulmonary systolic arterial pressure; SCL-70, anti-topoisomerase I antibodjes; SSc, systemic sclerosis; TAPSE, tricuspid annular plane systolic excursion.",
  "authors": [
    {
      "affiliations": [
        "Rheumatology Department, Uls Gaia Espinho, Vila Nova De Gaia, Portugal"
      ],
      "name": "Catarina Rua"
    },
    {
      "affiliations": [
        "Rheumatology Department, Uls Gaia Espinho, Vila Nova De Gaia, Portugal"
      ],
      "name": "Tiago Beirão"
    },
    {
      "affiliations": [
        "Rheumatology Department, Uls Gaia Espinho, Vila Nova De Gaia, Portugal"
      ],
      "name": "Catarina Silva"
    },
    {
      "affiliations": [
        "Rheumatology Department, Uls Gaia Espinho, Vila Nova De Gaia, Portugal"
      ],
      "name": "Mariana Patela"
    },
    {
      "affiliations": [
        "Rheumatology Department, Uls Gaia Espinho, Vila Nova De Gaia, Portugal"
      ],
      "name": "Tiago Meirinhos"
    },
    {
      "affiliations": [
        "Rheumatology Department, Uls Gaia Espinho, Vila Nova De Gaia, Portugal"
      ],
      "name": "Flavio Costa"
    }
  ],
  "title": "P.147 Prevalence and associated factors of resting electrocardiogram abnormalities in systemic sclerosis: a single-centre study",
  "uid": "0e264be2-af61-5861-96c0-45c5c126b4ec"
}