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Cardiac Autonomic Function in Patients with Systemic Sclerosis: The Impact of Exercise Training and Detraining
Maria Anifanti1, Andriana Teloudi1, Alexandros Mitropoulos2
1Laboratory of Sports Medicine, Department of Physical Education and Sports Science, Aristotle University of Thessaloniki, 57001 Thessaloniki, Greece.
Sports (Basel, Switzerland)
|August 27, 2025
Summary
Exercise training significantly improves cardiac autonomic nervous system function and cardiorespiratory efficiency in systemic sclerosis (SSc) patients. A three-month program enhanced heart rate variability and peak oxygen uptake, mitigating detraining effects.
Area of Science:
- Cardiology
- Exercise Physiology
- Rheumatology
Background:
- Systemic sclerosis (SSc) is linked to cardiac autonomic nervous system (CANS) dysfunction, increasing cardiovascular risks.
- Early CANS dysfunction in SSc precedes cardiac fibrosis, highlighting the need for interventions.
- Understanding the impact of exercise on CANS in SSc is crucial for patient management.
Purpose of the Study:
- To assess the effects of a three-month exercise training regimen and subsequent detraining on CANS activity in SSc patients.
- To evaluate changes in cardiorespiratory fitness, specifically peak oxygen uptake (VO2peak).
- To explore the relationship between cardiorespiratory fitness improvements and CANS function.
Main Methods:
- Forty SSc patients were randomized into an exercise training (ET) group or a control (CON) group.
- Cardiopulmonary exercise testing (VO2peak) and 24-hour ECG monitoring (heart rate variability, HRV) were conducted at baseline, 3, and 6 months.
- HRV analysis included time-domain (SDNN, rMSSD, pNN50) and frequency-domain (LF, HF, LF/HF ratio) indices.
Main Results:
- The ET group showed significant improvements in vagal activity (rMSSD, pNN50, HF) and sympathovagal balance (SDNN, LF/HF ratio) after 3 months.
- VO2peak increased by 20.8% in the ET group (p=0.001), with a strong positive correlation between VO2peak and SDNN changes (r=0.754).
- The CON group showed no significant changes at 3 months, and the ET group's improvements were not sustained at 6 months, while the CON group declined.
Conclusions:
- A three-month mixed-type exercise program effectively enhances cardiorespiratory fitness and CANS function in SSc patients.
- Exercise interventions can potentially mitigate the decline in CANS function observed during detraining periods.
- These findings suggest exercise is a valuable therapeutic strategy for managing cardiovascular autonomic dysfunction in SSc.
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