Heart rate turbulence assessment in systemic sclerosis: the role for the detection of cardiac autonomic nervous system dysfunction.
OBJECTIVE
To assess the heart rate turbulence (HRT) in patients with SSc as a method of assessment for cardiac autonomic nervous function.


METHODS
We prospectively studied 68 consecutive patients with SSc before inclusion in the study. After a detailed clinical evaluation, including echocardiography, 45 subjects [aged 54.6 (14.7) years; 40 women] underwent 24-h Holter monitoring for HRT and time- and frequency-domain heart rate variability (HRV) assessment. Results were compared with those in 30 age- and sex-matched healthy controls.


RESULTS
As compared with controls, HRT was impaired in SSc patients: the median turbulence onset (TO) was higher (P = 0.0001) and the median turbulence slope (TS) was lower (P = 0.0003). Abnormal HRT (TO > or =0.0% and/or TS < or =2.5 ms/RR) was found in 42% of SSc patients. Moreover, SSc duration correlated negatively with values of TS (r = -0.3; P = 0.045). HRT did not differ between diffuse and limited SSc groups. All estimated time- and the majority of frequency-domain values of HRV parameters in SSc were significantly lower than in controls. Significant correlations were also demonstrated between HRT and HRV parameters.


CONCLUSIONS
HRT, like HRV assessment, indicates a frequent impairment of the cardiac autonomic nervous system in SSc patients, irrespective of the SSc type.
Bienias
Piotr
P
Department of Internal Medicine and Cardiology, Medical University of Warsaw, 02-005 Warsaw, Lindleya 4, Poland. pbienias@mp.pl.
Ciurzyński
Michal
M
Glińska-Wielochowska
Maria
M
Szewczyk
Agnieszka
A
Korczak
Dariusz
D
Kalińska-Bienias
Agnieszka
A
Gliński
Wieslaw
W
Pruszczyk
Piotr
P
D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D001342:Autonomic Nervous System Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D016022:Case-Control Studies; D015716:Electrocardiography, Ambulatory / Q000379:methods; D005260:Female; D006321:Heart / Q000294:innervation; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012595:Scleroderma, Systemic / Q000150:complications* / Q000503:physiopathology