title: Pulmonary hypertension in systemic sclerosis determines cardiac autonomic dysfunction assessed by heart rate turbulence.
abstract: There is limited data on heart rate turbulence (HRT) in systemic sclerosis (SSc) patients, potentially threatened with cardiac autonomic dysfunction. We performed 24-hour Holter monitoring for HRT assessment in 45 patients with SSc and 30 healthy controls. Abnormal HRT defined as turbulence onset (TO) >or=0.0% and/or turbulence slope (TS)<or=2.5 ms/RR was found in 19 (42%) of SSc patients while not in controls. HRT was significantly impaired in SSc group, as compared to controls: a median of TO was higher (-0.13 vs. -2.45%, p=0.0001), and a median of TS was lower (6.90 vs. 13.21 ms/RR, p=0.0003), respectively. Multivariate analysis showed that abnormal HRT in SSc was significantly influenced by pulmonary hypertension (PH) (OR 6.1, 1.1-48.6; p=0.049) and older age (OR 1.8, 95%CI 1.1-3.5; p=0.03). In conclusion, HRT assessment indicates a frequent impairment of cardiac autonomic nervous system in SSc patients. Moreover, older age in these patients and especially PH are independent significant predictors of cardiac autonomic dysfunction.
authors.forename: Piotr
authors.initials: P
authors.lastname: Bienias
authors.forename: Michał
authors.initials: M
authors.lastname: Ciurzyński
authors.forename: Dariusz
authors.initials: D
authors.lastname: Korczak
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Jankowski
authors.forename: Maria
authors.initials: M
authors.lastname: Glińska-Wielochowska
authors.forename: Danuta
authors.initials: D
authors.lastname: Liszewska-Pfejfer
authors.forename: Wiesław
authors.initials: W
authors.lastname: Gliński
authors.forename: Piotr
authors.initials: P
authors.lastname: Pruszczyk
mesh_terms: D000328:Adult; D000368:Aged; D001342:Autonomic Nervous System Diseases / Q000150:complications* / Q000503:physiopathology*; D015716:Electrocardiography, Ambulatory; D005260:Female; D006321:Heart / Q000294:innervation / Q000502:physiology; D006339:Heart Rate; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012595:Scleroderma, Systemic / Q000150:complications* / Q000503:physiopathology*