Rheumatology International

, Volume 37, Issue 1, pp 49–57 | Cite as

Cardiac mechanics and heart rate variability in patients with systemic sclerosis: the association that we should not miss

  • Maja Zlatanovic
  • Marijana Tadic
  • Vera Celic
  • Branislava Ivanovic
  • Ana Stevanovic
  • Nemanja Damjanov
Observational Research
First Online:
Received:
Accepted:

Abstract

We aimed to determine left ventricular (LV) and right ventricular (RV) structure, function and mechanics, as well as heart rate variability (HRV), and their relationship, in patients with systemic sclerosis (SSc). The study included 41 SSc patients and 30 age-matched healthy volunteers. All the patients underwent clinical examination, serological tests, pulmonary function testing, 24-h Holter monitoring and complete two-dimensional echocardiography including strain analysis. The parameters of LV structure (interventricular septum thickness and LV mass index) and RV structure (RV wall thickness) were significantly higher in SSc patients. LV and RV diastolic function (estimated by mitral and tricuspid E/e′ ratio) was significantly impaired in SSc group comparing with the healthy controls. LV and RV longitudinal function was significantly deteriorated in SSc patients. LV circumferential strain was also significantly lower in SSc group, whereas LV radial strain was similar between the observed groups. All parameters of time and frequency domain of HRV were decreased in SSc patients. LV and RV cardiac remodeling parameters, particularly diastolic function and longitudinal strain, were associated with HRV indices without regard to the main demographic or the clinical and echocardiographic characteristics. Rodnan Skin Score was also independently associated with biventricular cardiac remodeling in SSc patients. LV and RV structure, function and mechanics, as well as autonomic nervous function, were significantly impaired in SSc patients. There is the significant association between biventricular cardiac remodeling and autonomic function in these patients, which could be useful for their everyday clinical assessment.

Keywords

Systemic sclerosis Heart Heart rate variability Mechanics 
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Notes

Compliance with ethical standards

Conflict of interest

Maja Zlatanovic, Marijana Tadic, Vera Celic, Branislava Ivanovic, Ana Stevanovic and Nemanja Damjanov declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Maja Zlatanovic
    • 1
  • Marijana Tadic
    • 2
  • Vera Celic
    • 2
    • 3
  • Branislava Ivanovic
    • 3
    • 4
  • Ana Stevanovic
    • 2
  • Nemanja Damjanov
    • 1
    • 3
  1. 1.Institute of RheumatologyBelgradeSerbia
  2. 2.Cardiology DepartmentUniversity Clinical Hospital Center “Dr. Dragisa Misovic - Dedinje”BelgradeSerbia
  3. 3.Faculty of MedicineBelgradeSerbia
  4. 4.Clinic of CardiologyClinical Centre of SerbiaBelgradeSerbia

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