TY - JOUR
T1 - The relationship between left ventricular deformation and heart rate variability in patients with systemic sclerosis
T2 - Two- and three-dimensional strain analysis
AU - Tadic, Marijana
AU - Zlatanovic, Maja
AU - Cuspidi, Cesare
AU - Ivanovic, Branislava
AU - Stevanovic, Ana
AU - Damjanov, Nemanja
AU - Kocijancic, Vesna
AU - Celic, Vera
PY - 2017/6/1
Y1 - 2017/6/1
N2 - Objective We sought to investigate left ventricular (LV) function and deformation, as well as heart rate variability (HRV), and their relationship, in patients with systemic sclerosis (SSc). Methods The study included 49 SSc patients and 38 age-matched healthy subjects. All patients underwent clinical examination, serological tests, 24-h Holter monitoring, and comprehensive two- and three-dimensional echocardiography (2DE and 3DE). Results 2DE and 3DE LV global longitudinal and circumferential strain, as well as 3DE area strains are significantly reduced in SSc patients comparing with controls. 2DE and 3DE LV radial strains are similar between the observed groups. 2DE LV layer-specific longitudinal and circumferential strains are also significantly affected by SSc. Parameters of cardiac autonomic nervous system, assessed by HRV indices, SDNN, SDANN, rMMSD, p50NN, 24-h HF, LF and TP are significantly lower in SSc group. HRV indices (24-h HF and LF) are associated with 2DE LV global, 2DE LV layer-specific and 3DE LV mechanics independently of main demographic, clinical and echocardiographic parameters of the study population. Additionally, Modified Rodnan Skin Score, clinical parameter of skin involvement in SSc, is significantly associated with HRV (24-h HF and LF), 2DE and 3DE LV deformation. Conclusion SSc significantly impacts LV deformation, all myocardial layers, and cardiac autonomic nervous function. A significant association between cardiac autonomic nervous system function, skin involvement and LV mechanics is revealed in SSc patients. These findings should encourage detailed cardiac assessment and further cardiac follow-up of the SSc patients with higher skin involvement, even when traditional echocardiographic parameters are within normal range.
AB - Objective We sought to investigate left ventricular (LV) function and deformation, as well as heart rate variability (HRV), and their relationship, in patients with systemic sclerosis (SSc). Methods The study included 49 SSc patients and 38 age-matched healthy subjects. All patients underwent clinical examination, serological tests, 24-h Holter monitoring, and comprehensive two- and three-dimensional echocardiography (2DE and 3DE). Results 2DE and 3DE LV global longitudinal and circumferential strain, as well as 3DE area strains are significantly reduced in SSc patients comparing with controls. 2DE and 3DE LV radial strains are similar between the observed groups. 2DE LV layer-specific longitudinal and circumferential strains are also significantly affected by SSc. Parameters of cardiac autonomic nervous system, assessed by HRV indices, SDNN, SDANN, rMMSD, p50NN, 24-h HF, LF and TP are significantly lower in SSc group. HRV indices (24-h HF and LF) are associated with 2DE LV global, 2DE LV layer-specific and 3DE LV mechanics independently of main demographic, clinical and echocardiographic parameters of the study population. Additionally, Modified Rodnan Skin Score, clinical parameter of skin involvement in SSc, is significantly associated with HRV (24-h HF and LF), 2DE and 3DE LV deformation. Conclusion SSc significantly impacts LV deformation, all myocardial layers, and cardiac autonomic nervous function. A significant association between cardiac autonomic nervous system function, skin involvement and LV mechanics is revealed in SSc patients. These findings should encourage detailed cardiac assessment and further cardiac follow-up of the SSc patients with higher skin involvement, even when traditional echocardiographic parameters are within normal range.
KW - Heart rate variability
KW - Left ventricle
KW - Strain
KW - Systemic sclerosis
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U2 - 10.1016/j.ijcard.2017.02.043
DO - 10.1016/j.ijcard.2017.02.043
M3 - Article
AN - SCOPUS:85013070446
VL - 236
SP - 145
EP - 150
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -