Department of Internal Medicine and Cardiology, Medical University of Warsaw, 02-005 Warsaw, Lindleya 4, Poland.
Rheumatology (Oxford). 2010 Feb;49(2):355-60. doi: 10.1093/rheumatology/kep394. Epub 2009 Dec 9.
To assess the heart rate turbulence (HRT) in patients with SSc as a method of assessment for cardiac autonomic nervous function.
We prospectively studied 68 consecutive patients with SSc before inclusion in the study. After a detailed clinical evaluation, including echocardiography, 45 subjects [aged 54.6 (14.7) years; 40 women] underwent 24-h Holter monitoring for HRT and time- and frequency-domain heart rate variability (HRV) assessment. Results were compared with those in 30 age- and sex-matched healthy controls.
As compared with controls, HRT was impaired in SSc patients: the median turbulence onset (TO) was higher (P = 0.0001) and the median turbulence slope (TS) was lower (P = 0.0003). Abnormal HRT (TO > or =0.0% and/or TS < or =2.5 ms/RR) was found in 42% of SSc patients. Moreover, SSc duration correlated negatively with values of TS (r = -0.3; P = 0.045). HRT did not differ between diffuse and limited SSc groups. All estimated time- and the majority of frequency-domain values of HRV parameters in SSc were significantly lower than in controls. Significant correlations were also demonstrated between HRT and HRV parameters.
HRT, like HRV assessment, indicates a frequent impairment of the cardiac autonomic nervous system in SSc patients, irrespective of the SSc type.
评估系统性硬化症（SSc）患者的心率震荡（HRT），作为评估心脏自主神经功能的方法。
我们前瞻性地研究了 68 例连续的 SSc 患者，在纳入研究之前进行了详细的临床评估，包括超声心动图。45 名患者[年龄 54.6（14.7）岁；40 名女性]接受了 24 小时动态 Holter 监测，以进行 HRT 和时域及频域心率变异性（HRV）评估。结果与 30 名年龄和性别匹配的健康对照进行了比较。
与对照组相比，HRT 在 SSc 患者中受损：震荡起始（TO）中位数较高（P = 0.0001），震荡斜率（TS）中位数较低（P = 0.0003）。42%的 SSc 患者存在异常 HRT（TO >或= 0.0%和/或 TS <或= 2.5 ms/RR）。此外，SSc 病程与 TS 值呈负相关（r = -0.3；P = 0.045）。弥漫性和局限性 SSc 组之间的 HRT 无差异。所有估计的时域和大部分频域 HRV 参数值在 SSc 中均显著低于对照组。HRT 与 HRV 参数之间也存在显著相关性。
与 HRV 评估一样，HRT 表明 SSc 患者心脏自主神经系统经常受损，与 SSc 类型无关。
