Regional myocardial dysfunction assessed by two-dimensional speckle tracking echocardiography in systemic sclerosis patients with fragmented QRS complexes

• To the best of our knowledge, this is the first study in the literature to evaluate regional myocardial function with 2D STE in SSc patients with fQRS complexes in surface ECG.
• We showed that SSc patients had subclinical myocardial dysfunction assessed by 2D STE while conventional echocardiographic measures were normal.
• Additionally, we detected fQRS complexes in SSc patients and these patients had significantly lower LV GLS and GCS when compared to SSc patients with normal QRS complexes.
• Our results have suggested that surface ECG might be useful for early detection of myocardial involvement in SSc patient and would rather be performed in every SSc patient suspected from myocardial dysfunction

BackgroundThe aim of the study was to explore the relation between regional myocardial dysfunction and fragmented QRS (fQRS) complexes in systemic sclerosis (SSc).MethodsFifty-three SSc patients and 26 controls were included. All subjects underwent speckle tracking echocardiography for evaluation of left ventricular (LV) function and ECG to check for fQRS complexes.ResultsSSc patients had significantly lower LV global longitudinal, radial and circumferential strain and twist compared to controls. Thirteen SSc patients had fQRS (DII, DIII, aVF leads in eleven patients and V1 to V5 leads in two patients) and they had significantly lower global longitudinal and circumferencial strain compared to SSc patients with normal QRS. The SSc patients with fQRS in DII, DIII, and aVF leads had impaired longitudinal strain and delay in time to peak longitudinal strain in inferior LV segments compared to those with normal QRS.ConclusionfQRS is associated with lower strain measures in SSc patients indicating impairment in LV function.