title: Cardiac mechanics and heart rate variability in patients with systemic sclerosis: the association that we should not miss.
abstract: We aimed to determine left ventricular (LV) and right ventricular (RV) structure, function and mechanics, as well as heart rate variability (HRV), and their relationship, in patients with systemic sclerosis (SSc). The study included 41 SSc patients and 30 age-matched healthy volunteers. All the patients underwent clinical examination, serological tests, pulmonary function testing, 24-h Holter monitoring and complete two-dimensional echocardiography including strain analysis. The parameters of LV structure (interventricular septum thickness and LV mass index) and RV structure (RV wall thickness) were significantly higher in SSc patients. LV and RV diastolic function (estimated by mitral and tricuspid E/e' ratio) was significantly impaired in SSc group comparing with the healthy controls. LV and RV longitudinal function was significantly deteriorated in SSc patients. LV circumferential strain was also significantly lower in SSc group, whereas LV radial strain was similar between the observed groups. All parameters of time and frequency domain of HRV were decreased in SSc patients. LV and RV cardiac remodeling parameters, particularly diastolic function and longitudinal strain, were associated with HRV indices without regard to the main demographic or the clinical and echocardiographic characteristics. Rodnan Skin Score was also independently associated with biventricular cardiac remodeling in SSc patients. LV and RV structure, function and mechanics, as well as autonomic nervous function, were significantly impaired in SSc patients. There is the significant association between biventricular cardiac remodeling and autonomic function in these patients, which could be useful for their everyday clinical assessment.
authors.affiliation: Institute of Rheumatology, Resavska 69, 11000, Belgrade, Serbia. zlatanovic_maja@yahoo.com.
authors.forename: Maja
authors.initials: M
authors.lastname: Zlatanovic
authors.affiliation: Cardiology Department, University Clinical Hospital Center "Dr. Dragisa Misovic - Dedinje", Heroja Milana Tepica 1, 11000, Belgrade, Serbia.
authors.forename: Marijana
authors.initials: M
authors.lastname: Tadic
authors.affiliation: Cardiology Department, University Clinical Hospital Center "Dr. Dragisa Misovic - Dedinje", Heroja Milana Tepica 1, 11000, Belgrade, Serbia.|Faculty of Medicine, Doktora Subotica 6, 11000, Belgrade, Serbia.
authors.forename: Vera
authors.initials: V
authors.lastname: Celic
authors.affiliation: Faculty of Medicine, Doktora Subotica 6, 11000, Belgrade, Serbia.|Clinic of Cardiology, Clinical Centre of Serbia, Koste Todorovic 8, 11000, Belgrade, Serbia.
authors.forename: Branislava
authors.initials: B
authors.lastname: Ivanovic
authors.affiliation: Cardiology Department, University Clinical Hospital Center "Dr. Dragisa Misovic - Dedinje", Heroja Milana Tepica 1, 11000, Belgrade, Serbia.
authors.forename: Ana
authors.initials: A
authors.lastname: Stevanovic
authors.affiliation: Institute of Rheumatology, Resavska 69, 11000, Belgrade, Serbia.|Faculty of Medicine, Doktora Subotica 6, 11000, Belgrade, Serbia.
authors.forename: Nemanja
authors.initials: N
authors.lastname: Damjanov
mesh_terms: D000328:Adult; D000368:Aged; D015716:Electrocardiography, Ambulatory; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012595:Scleroderma, Systemic / Q000503:physiopathology*; D016277:Ventricular Function, Left / Q000502:physiology*; D016278:Ventricular Function, Right / Q000502:physiology*; D020257:Ventricular Remodeling / Q000502:physiology
keywords: Heart; Heart rate variability; Mechanics; Systemic sclerosis