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Autonomic dysfunction and microvascular damage in systemic sclerosis.

Manuela Di Franco1, Michele Paradiso, Valeria Riccieri

  • 1Dipartimento di Clinica e Terapia Medica Applicata, UOC di Medicina Interna, Università di Roma La Sapienza, and Unità di Riabilitazione Intensiva Neuromotoria, Ospedale San Giovanni Battista, Ordine di Malta, Rome, Italy. manuela.difranco@uniroma1.it

Clinical Rheumatology
|January 20, 2007
PubMed
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Systemic sclerosis patients show reduced heart rate variability (HRV) and increased microvascular damage. Autonomic dysfunction and severe microvascular damage may predict cardiac mortality risk in SSc.

Area of Science:

  • Cardiology
  • Rheumatology
  • Autonomic Neuroscience

Background:

  • Systemic sclerosis (SSc) is a connective tissue disease causing widespread organ damage, including vascular and fibrotic changes.
  • Cardiac involvement is a significant concern in SSc, but early detection of autonomic dysfunction is challenging.

Purpose of the Study:

  • To evaluate cardiac autonomic function using heart rate variability (HRV) and microvascular damage via nailfold capillaroscopy (NC) in SSc patients.
  • To explore the relationship between autonomic dysfunction and microvascular damage in SSc.

Main Methods:

  • 25 SSc outpatients and 25 healthy controls underwent 24-h Holter monitoring for HRV analysis and nailfold capillaroscopy (NC).
  • HRV was assessed using time-domain parameters (SDNN, SDANN, pNN50). NC abnormalities were scored semiquantitatively.

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Main Results:

  • SSc patients exhibited significantly lower HRV parameters (SDNN, SDANN, pNN50) compared to controls.
  • These HRV parameters correlated negatively with the severity of nailfold capillaroscopy abnormalities.
  • Worsening microvascular damage in SSc was associated with more pronounced autonomic dysfunction.

Conclusions:

  • Abnormal cardiac autonomic control, indicated by reduced HRV, is present in SSc patients.
  • The combination of autonomic dysfunction and severe microvascular damage may serve as a prognostic indicator for cardiac mortality risk in SSc.