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Observational Study
. 2025 Jun;44(6):2377-2386.
doi: 10.1007/s10067-025-07477-x. Epub 2025 May 10.

A retrospective study of electrocardiographic alterations in primary Sjögren's syndrome: role of anti-SSA positivity and disease duration

Sibel Ösken  1 , Altuğ Ösken  2 , Fuat Polat  3 , Duygu Şahin  1 , Nihan Neval Uzun  1 , Nesrin Şen  1 , Mehmet Engin Tezcan  1
Affiliations
Observational Study

A retrospective study of electrocardiographic alterations in primary Sjögren's syndrome: role of anti-SSA positivity and disease duration

Sibel Ösken et al. Clin Rheumatol. 2025 Jun.

Abstract

Background: Primary Sjögren's Syndrome (pSS) is a chronic autoimmune disorder affecting exocrine glands and potentially leading to cardiovascular complications. The impact of anti-SSA antibody seropositivity on cardiac function, particularly ECG parameters, is not well understood.

Aims: This study aims to explore the association between anti-SSA antibody seropositivity and various ECG parameters, including the QT interval, corrected QT interval (QTc), QT dispersion, and T peak to T end (TP-TE) interval, in patients with pSS.

Methods: A retrospective observational study was conducted involving 57 pSS patients. Participants were divided into seropositive (n = 32) and seronegative (n = 25) groups based on anti-SSA antibody status. ECG parameters were assessed, including QT interval, QTc interval, QT dispersion, and TP-TE interval. Statistical comparisons were made using independent t-tests, Mann-Whitney U tests, or chi-square tests, with a significance threshold of p < 0.05.

Results: The seropositive group showed significantly prolonged QT interval (403.1 ± 28.7 ms) compared to the seronegative group (381.8 ± 28.2 ms, p < 0.01). Similarly, the QTc interval was longer in seropositive patients (430.1 ± 28.6 ms) compared to seronegative patients (412.6 ± 31.8 ms, p = 0.03). QT dispersion was greater in the seropositive group (43.5 ± 3.6 ms) compared to the seronegative group (40.8 ± 4.6 ms, p = 0.02). The TP-TE interval was also significantly prolonged in seropositive patients (67.9 ± 7.5 ms) compared to seronegative patients (63.4 ± 4.8 ms, p < 0.01). The TP-TE/QTc ratio did not differ significantly between the two groups.

Conclusions: Anti-SSA seropositivity in pSS patients is associated with significant alterations in ECG parameters indicative of impaired ventricular repolarization. These findings suggest that seropositive pSS patients may have an increased risk of cardiovascular complications, emphasizing the importance of ECG monitoring in this patient population. Key Points •Anti-Ro/SSA seropositivity in pSS patients is linked to prolonged QT and QTc intervals, indicating impaired ventricular repolarization. •Seropositive pSS patients show increased QT dispersion, which may reflect a higher risk for arrhythmias. •The TP-TE interval is significantly prolonged in seropositive pSS patients, suggesting a higher risk for ventricular arrhythmias. •ECG monitoring is crucial in seropositive pSS patients to detect early cardiac abnormalities and guide treatment.

Keywords: Anti-SSA antibodies; ECG parameters; Primary Sjögren’s syndrome; Ventricular depolarization.

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Conflict of interest statement

Declarations. Ethical approval: The study was approved by Kartal Dr. Lutfi Kirdar City Hospital Ethical Committee (Decision date and number: 2023/514/250/13). Conflict of interest: Sibel Ösken, Altuğ Ösken, Fuat Polat, Duygu Sahin, Nihan Neval Uzun, Nesrin Sen, Mehmet Engin Tezcan declare that they have no conflict of interest.

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