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Published on: March 4, 2014
Autonomic dysfunction predicts early cardiac affection in patients with systemic sclerosis
Khaled M Othman1, Naglaa Youssef Assaf, Hanan Mohamed Farouk
1The Departments of Cardiology.
Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders
|December 3, 2010
Summary
Systemic sclerosis (SSc) patients show early cardiac autonomic dysfunction and altered cardiac function. Noninvasive heart rate variability (HRV) assessment can identify high-risk individuals for early intervention.
Area of Science:
- Cardiology
- Rheumatology
- Autonomic Neuroscience
Background:
- Systemic sclerosis (SSc) is a multisystem autoimmune disease.
- Cardiac involvement is a major cause of morbidity and mortality in SSc.
- Early detection of cardiac dysfunction is crucial for timely intervention.
Purpose of the Study:
- To identify early preclinical alterations in cardiac autonomic control and function in SSc patients.
- To correlate these cardiac changes with clinical features of SSc.
- To utilize noninvasive methods for assessment.
Main Methods:
- 30 SSc patients and 15 healthy controls underwent clinical and serological evaluation.
- Echocardiography with Doppler flow imaging assessed cardiac function.
- 24-hour Holter monitoring analyzed arrhythmia and heart rate variability (HRV).
Main Results:
- SSc patients exhibited reversed trans-mitral and tricuspid E/A ratios, indicating diastolic dysfunction.
- Increased prevalence of premature ventricular contractions (PVCs) and supra-ventricular tachycardias (SVTs) were observed.
- Significant impairment in all HRV parameters was noted in SSc patients, correlating with disease severity markers like skin thickness and anti-SCL70 antibodies.
Conclusions:
- Low heart rate variability (HRV) and specific autoantibodies (anti-SCL70) are linked to preclinical cardiac involvement in SSc.
- These findings may predict the risk of malignant arrhythmias and sudden cardiac death.
- Noninvasive HRV evaluation can aid in early risk stratification and management of SSc patients.
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