title: Assessment of cardiac autonomic nervous system involvement in systemic sclerosis via exercise heart rate recovery.
abstract: OBJECTIVE
  To assess exercise heart rate recovery (HRR) indices in patients with systemic sclerosis (SSc) for an assessment of their cardiac autonomic function.
  
  
  METHODS
  Thirty-five patients with diffuse or limited SSc and 35 healthy controls were enrolled. All subjects underwent exercise testing and transthoracic echocardiography. The HRR indices were calculated by subtracting the first- (HRR1), second- (HRR2) and third-minute (HRR3) heart rates from the maximal heart rate.
  
  
  RESULTS
  The SSc and control groups were similar in age (45.2 ± 11.6 vs. 43.9 ± 10.0 years), had identical gender ratios (31 female/4 male in both groups) and similar left ventricular ejection fraction (66.5 ± 5.1 vs. 67.7 ± 5.9%). The mean HRR1 (21.8 ± 4.4 vs. 27.7 ± 4.3 bpm, p = 0.001), HRR2 (43.8 ± 6.3 vs. 47.6 ± 4.4 bpm, p = 0.004) and HRR3 (58.8 ± 10.3 vs. 63.6 ± 7.3 bpm, p = 0.031) values were significantly lower in the SSc group than in the healthy controls. HRR indices were similar in the limited and diffuse SSc subgroups.
  
  
  CONCLUSIONS
  The patients with SSc had lower HRR indices than normal subjects. Cardiac autonomic functions might be involved in SSc, even in patients without cardiac symptoms.
authors.affiliation: Department of Cardiology, Division of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Ugur Nadir
authors.initials: UN
authors.lastname: Karakulak
authors.forename: Sercan
authors.initials: S
authors.lastname: Okutucu
authors.forename: Levent
authors.initials: L
authors.lastname: Şahiner
authors.forename: Naresh
authors.initials: N
authors.lastname: Maharjan
authors.forename: Elifcan
authors.initials: E
authors.lastname: Aladag
authors.forename: Ali
authors.initials: A
authors.lastname: Akdogan
authors.forename: Levent
authors.initials: L
authors.lastname: Kilic
authors.forename: Ergun Baris
authors.initials: EB
authors.lastname: Kaya
authors.forename: Kudret
authors.initials: K
authors.lastname: Aytemir
authors.forename: Lale
authors.initials: L
authors.lastname: Tokgozoglu
mesh_terms: D000328:Adult; D001341:Autonomic Nervous System / Q000502:physiology; D002320:Cardiovascular Physiological Phenomena; D002319:Cardiovascular System; D016022:Case-Control Studies; D004452:Echocardiography; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012595:Scleroderma, Systemic / Q000503:physiopathology*; D013318:Stroke Volume / Q000502:physiology; D014421:Turkey