Association of electrocardiographic altered P wave dispersion and vascular endothelial growth factor in rheumatoid arthritis

IF 1.2 Q4 RHEUMATOLOGY

Reumatologia Clinica Pub Date : 2025-04-01 DOI:10.1016/j.reuma.2025.501856

Osmar Antonio Centurión , Paloma de Abreu , Gabriela Avila-Pedretti , Sonia R. Cabrera , María T. Martínez de Filártiga , Astrid Paats , Judith M. Torales , Christian O. Chávez , Carmen R. Montiel , Laura B. García , Karina E. Scavenius , Rocío del Pilar Falcón , Jose C. Candia , Alfredo J. Meza , Isabel Acosta-Colmán

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引用次数: 0

Abstract

Objectives

Serum vascular endothelial growth factor (VEGF) levels correlate with structural alterations in Rheumatoid Arthritis (RA). Since P wave dispersion (PWD) is associated with atrial ischemic-related fibrotic changes, it was conceived that there may be a correlation between altered PWD and increased VEGF levels in RA.

Methods

In this prospective observational study, we evaluated patients with RA, and compared them to control subjects. PWD was considered as the difference between the maximum and minimum duration of the P wave. An altered PWD was considered one that had dispersion ≥ 38 ms. Measurements of VEGF serum levels were performed using enzyme-ligand, immunosorbent measurement ELISA kits.

Results

A total of 99 patients with RA, and 48 control subjects were evaluated. The PWD was 25.3 ± 4.9 ms in the control group vs. 57 ± 14.9 ms (p < 0.0001) in the RA group. No patient in the control group had altered PWD, while 94 (95%) patients in the RA group presented it (p < 0.0001). The value of VEGF in the control group was 15.2 ± 15.1 pg/ml vs 51.1 ± 55.5 pg/ml (p < 0.001) in RA. The value of VEGF in RA without altered PWD was 20 ± 12 pg/ml vs 56 ± 57 pg/ml in RA with altered PWD (p < 0.02). An elevated VEGF value had a specificity of 80%, and a positive predictive accuracy of 95% in predicting altered PWD in RA.

Conclusions

This study establishes for the first time that RA patients who possess significantly higher serum levels of VEGF have an altered PWD. The presence of an elevated VEGF serum value has a high specificity, and high positive predictive accuracy of the existence of altered PWD in RA.

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类风湿关节炎患者心电图P波弥散改变与血管内皮生长因子的关系

目的：血清血管内皮生长因子（VEGF）水平与类风湿关节炎（RA）的结构改变相关。由于P波弥散度（PWD）与心房缺血相关的纤维化改变有关，因此我们认为RA中PWD改变与VEGF水平升高可能存在相关性。方法在这项前瞻性观察性研究中，我们对RA患者进行评估，并将其与对照组进行比较。PWD被认为是P波最大持续时间与最小持续时间之差。改变的PWD被认为弥散≥38 ms。采用酶配体、免疫吸附测定ELISA试剂盒测定血清VEGF水平。结果共对99例RA患者和48例对照组进行评估。对照组PWD为25.3±4.9 ms，对照组为57±14.9 ms (p <；0.0001)。对照组无PWD改变，而RA组有94例（95%）患者出现PWD改变(p <；0.0001)。对照组VEGF值分别为15.2±15.1 pg/ml vs 51.1±55.5 pg/ml (p <；0.001)。未改变PWD的RA组VEGF值为20±12 pg/ml，而改变PWD的RA组VEGF值为56±57 pg/ml (p <；0.02)。VEGF升高在预测RA患者PWD改变方面的特异性为80%，阳性预测准确率为95%。结论本研究首次证实血清VEGF水平显著升高的RA患者PWD发生改变。VEGF血清值升高对RA中PWD改变的存在具有高特异性和高阳性预测准确性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Reumatologia Clinica RHEUMATOLOGY-

CiteScore

2.40

自引率

6.70%

发文量

105

审稿时长

54 days

期刊介绍： Una gran revista para cubrir eficazmente las necesidades de conocimientos en una patología de etiología, expresividad clínica y tratamiento tan amplios. Además es La Publicación Oficial de la Sociedad Española de Reumatología y del Colegio Mexicano de Reumatología y está incluida en los más prestigiosos índices de referencia en medicina.