Cardiac autonomic modulation at rest and during orthostatic stress among different systemic sclerosis subsets

Gabriel Dias Rodrigues, Eleonora Tobaldini, Chiara Bellocchi, Alessandro Santaniello, Monica Caronni, Adriana Severino, Marco Froldi, Lorenzo Beretta, Pedro Paulo da Silva Soares, Nicola Montano

Research output: Contribution to journalArticle

Abstract

Objective: To compare autonomic heart rate variability (HRV) parameters at rest and during active stand in a population of SSc patients, taking into account SSc subsets age-matched to healthy control subjects. Methods: Sixty-nine consecutive SSc patients were enrolled in study; these included 12 subjects with early SSc, 39 with limited cutaneous (lcSSc) and 18 with diffuse cutaneous SSc (dcSSc) along with 36 age- and sex-matched healthy controls (HC). ECG and respiration were recorded in supine position and in orthostatism (ORT). HRV analysis was performed on samples of 300 beats. Spectral analysis identified two oscillatory components, low frequency (LFnu, sympathetic) and high frequency (HFnu, vagal). Symbolic analysis identified three patterns, 0 V%, (sympathetic) and 2UV% and 2LV%, (vagal). The %∆ORT was calculated from the differences between HRV in ORT and SUP, normalized (%) by the HRV values at rest. Results: SSc as a whole had higher markers of sympathetic (LF, 0 V%) and lower markers of vagal modulation (HR, 2UV%, 2LV%) compared to HCs. In addition, %∆LFnu, %∆HFnu, %∆0 V, %∆2UV and %∆2LV were lower in SSc than HC. dcSSc and lcSSc were dissimilar to HC as far as rest indexes were concerned (↑LF/HF, ↑LFnu, ↓HFnu, ↑0 V% and ↓2UV%) while no differences could be detected between HC and EaSSc. Conclusion: SSc showed a reduced vagal and increased sympathetic modulation at rest and a blunted autonomic response to ORT in comparison to HC. These alterations were mostly detectable in the advanced and fibrotic forms of SSc (dcSSc and lcSSc), while EaSSc were similar to HC.

Original languageEnglish
Pages (from-to)75-80
JournalEuropean Journal of Internal Medicine
Volume66
DOIs
Publication statusPublished - Jan 1 2019

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Systemic Scleroderma
Heart Rate
Skin
Supine Position
Healthy Volunteers
Electrocardiography
Respiration
Population

Keywords

  • Autoimmune diseases
  • Heart rate variability
  • Scleroderma
  • Symbolic analysis

ASJC Scopus subject areas

  • Internal Medicine

Cite this

@article{f817a4b1bb394d73aa4aded4d0f7d7c5,
title = "Cardiac autonomic modulation at rest and during orthostatic stress among different systemic sclerosis subsets",
abstract = "Objective: To compare autonomic heart rate variability (HRV) parameters at rest and during active stand in a population of SSc patients, taking into account SSc subsets age-matched to healthy control subjects. Methods: Sixty-nine consecutive SSc patients were enrolled in study; these included 12 subjects with early SSc, 39 with limited cutaneous (lcSSc) and 18 with diffuse cutaneous SSc (dcSSc) along with 36 age- and sex-matched healthy controls (HC). ECG and respiration were recorded in supine position and in orthostatism (ORT). HRV analysis was performed on samples of 300 beats. Spectral analysis identified two oscillatory components, low frequency (LFnu, sympathetic) and high frequency (HFnu, vagal). Symbolic analysis identified three patterns, 0 V{\%}, (sympathetic) and 2UV{\%} and 2LV{\%}, (vagal). The {\%}∆ORT was calculated from the differences between HRV in ORT and SUP, normalized ({\%}) by the HRV values at rest. Results: SSc as a whole had higher markers of sympathetic (LF, 0 V{\%}) and lower markers of vagal modulation (HR, 2UV{\%}, 2LV{\%}) compared to HCs. In addition, {\%}∆LFnu, {\%}∆HFnu, {\%}∆0 V, {\%}∆2UV and {\%}∆2LV were lower in SSc than HC. dcSSc and lcSSc were dissimilar to HC as far as rest indexes were concerned (↑LF/HF, ↑LFnu, ↓HFnu, ↑0 V{\%} and ↓2UV{\%}) while no differences could be detected between HC and EaSSc. Conclusion: SSc showed a reduced vagal and increased sympathetic modulation at rest and a blunted autonomic response to ORT in comparison to HC. These alterations were mostly detectable in the advanced and fibrotic forms of SSc (dcSSc and lcSSc), while EaSSc were similar to HC.",
keywords = "Autoimmune diseases, Heart rate variability, Scleroderma, Symbolic analysis",
author = "Rodrigues, {Gabriel Dias} and Eleonora Tobaldini and Chiara Bellocchi and Alessandro Santaniello and Monica Caronni and Adriana Severino and Marco Froldi and Lorenzo Beretta and {da Silva Soares}, {Pedro Paulo} and Nicola Montano",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.ejim.2019.06.003",
language = "English",
volume = "66",
pages = "75--80",
journal = "European Journal of Internal Medicine",
issn = "0953-6205",
publisher = "Elsevier B.V.",

}

TY - JOUR

T1 - Cardiac autonomic modulation at rest and during orthostatic stress among different systemic sclerosis subsets

AU - Rodrigues, Gabriel Dias

AU - Tobaldini, Eleonora

AU - Bellocchi, Chiara

AU - Santaniello, Alessandro

AU - Caronni, Monica

AU - Severino, Adriana

AU - Froldi, Marco

AU - Beretta, Lorenzo

AU - da Silva Soares, Pedro Paulo

AU - Montano, Nicola

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objective: To compare autonomic heart rate variability (HRV) parameters at rest and during active stand in a population of SSc patients, taking into account SSc subsets age-matched to healthy control subjects. Methods: Sixty-nine consecutive SSc patients were enrolled in study; these included 12 subjects with early SSc, 39 with limited cutaneous (lcSSc) and 18 with diffuse cutaneous SSc (dcSSc) along with 36 age- and sex-matched healthy controls (HC). ECG and respiration were recorded in supine position and in orthostatism (ORT). HRV analysis was performed on samples of 300 beats. Spectral analysis identified two oscillatory components, low frequency (LFnu, sympathetic) and high frequency (HFnu, vagal). Symbolic analysis identified three patterns, 0 V%, (sympathetic) and 2UV% and 2LV%, (vagal). The %∆ORT was calculated from the differences between HRV in ORT and SUP, normalized (%) by the HRV values at rest. Results: SSc as a whole had higher markers of sympathetic (LF, 0 V%) and lower markers of vagal modulation (HR, 2UV%, 2LV%) compared to HCs. In addition, %∆LFnu, %∆HFnu, %∆0 V, %∆2UV and %∆2LV were lower in SSc than HC. dcSSc and lcSSc were dissimilar to HC as far as rest indexes were concerned (↑LF/HF, ↑LFnu, ↓HFnu, ↑0 V% and ↓2UV%) while no differences could be detected between HC and EaSSc. Conclusion: SSc showed a reduced vagal and increased sympathetic modulation at rest and a blunted autonomic response to ORT in comparison to HC. These alterations were mostly detectable in the advanced and fibrotic forms of SSc (dcSSc and lcSSc), while EaSSc were similar to HC.

AB - Objective: To compare autonomic heart rate variability (HRV) parameters at rest and during active stand in a population of SSc patients, taking into account SSc subsets age-matched to healthy control subjects. Methods: Sixty-nine consecutive SSc patients were enrolled in study; these included 12 subjects with early SSc, 39 with limited cutaneous (lcSSc) and 18 with diffuse cutaneous SSc (dcSSc) along with 36 age- and sex-matched healthy controls (HC). ECG and respiration were recorded in supine position and in orthostatism (ORT). HRV analysis was performed on samples of 300 beats. Spectral analysis identified two oscillatory components, low frequency (LFnu, sympathetic) and high frequency (HFnu, vagal). Symbolic analysis identified three patterns, 0 V%, (sympathetic) and 2UV% and 2LV%, (vagal). The %∆ORT was calculated from the differences between HRV in ORT and SUP, normalized (%) by the HRV values at rest. Results: SSc as a whole had higher markers of sympathetic (LF, 0 V%) and lower markers of vagal modulation (HR, 2UV%, 2LV%) compared to HCs. In addition, %∆LFnu, %∆HFnu, %∆0 V, %∆2UV and %∆2LV were lower in SSc than HC. dcSSc and lcSSc were dissimilar to HC as far as rest indexes were concerned (↑LF/HF, ↑LFnu, ↓HFnu, ↑0 V% and ↓2UV%) while no differences could be detected between HC and EaSSc. Conclusion: SSc showed a reduced vagal and increased sympathetic modulation at rest and a blunted autonomic response to ORT in comparison to HC. These alterations were mostly detectable in the advanced and fibrotic forms of SSc (dcSSc and lcSSc), while EaSSc were similar to HC.

KW - Autoimmune diseases

KW - Heart rate variability

KW - Scleroderma

KW - Symbolic analysis

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JF - European Journal of Internal Medicine

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