Autonomic dysfunction in systemic sclerosis: time and frequency domain 24 hour heart rate variability analysis

Area of Science:

• Cardiology
• Neurology
• Rheumatology

Background:

• Systemic sclerosis (SSc) is an autoimmune disease affecting connective tissues.
• Autonomic nervous system dysfunction is a known complication of SSc.
• Cardiac involvement in SSc can significantly impact patient prognosis.

Purpose of the Study:

• To assess autonomic cardiac control in SSc patients.
• To investigate heart rate variability (HRV) as a marker of autonomic dysfunction in SSc.
• To identify predictors of mortality in SSc patients related to cardiac autonomic function.

Main Methods:

• Utilized 24-hour ambulatory ECG recordings for heart rate variability analysis.
• Employed time-domain and spectrum analysis techniques to evaluate HRV.
• Compared HRV parameters between 30 SSc patients and 30 age-matched healthy controls.

Main Results:

• SSc patients exhibited significantly higher heart rates compared to controls (P < 0.01).
• Circadian and spectral indices of heart rate variability were significantly lower in SSc patients (P < 0.01).
• Age, tachycardia, and HRV parameters predicted patient mortality; older patients with anti-Scl70 had higher mortality risk.

Conclusions:

• SSc patients demonstrate significant autonomic cardiac neuropathy.
• Reduced heart rate variability is a key indicator of cardiac autonomic dysfunction in SSc.
• Non-invasive HRV analysis is a feasible approach to detect autonomic neuropathy and predict mortality in SSc.