Second Internal Medicine Clinic, Department of Cardiovascular and Thoracic Sciences, University of Padua, Padova, Italy.
Int J Gen Med. 2012;5:339-43. doi: 10.2147/IJGM.S29822. Epub 2012 Apr 13.
the correlation between primary antiphospholipid syndrome (APS) and cardiovascular events is well known, but the correlation between APS and sudden death is not clear; it probably correlates with sympathetic alterations of the autonomic system.
To compare the autonomic nervous system (ANS) in a group of subjects suffering from APS against that of a control group with no cardiovascular risk factors, matched for age, sex, and body mass index.
An equal number (n = 31) of subjects with APS, and healthy controls, underwent autonomic evaluation: tilt test, deep breath, Valsalva maneuver, hand grip, lying-to-standing, Stroop, and sweat tests.
Cases in the APS group were positive for the tilt test, relating to changes in respiratory rate intervals, by comparison with controls. Results of other tests were also altered significantly in APS cases, by comparison with controls. (The sweat and Stroop tests were only performed in 14 cases). Autonomic disease did not correlate with age, sex, history of disease, arterial or venous thrombosis, or antibody positivity; only their coagulation parameters correlated with autonomic dysfunction.
Autonomic dysfunction in APS seems to correlate with coagulation parameters. APS patients should receive autonomic evaluation, to minimize the risks of fatal arrhythmias and sudden death.
原发性抗磷脂综合征（APS）与心血管事件之间的相关性是众所周知的，但 APS 与猝死之间的相关性尚不清楚；它可能与自主神经系统的交感神经改变有关。
比较一组患有 APS 的患者与无心血管危险因素的对照组的自主神经系统（ANS），对照组在年龄、性别和体重指数方面相匹配。
数量相等（n=31）的 APS 患者和健康对照者接受自主神经评估：倾斜试验、深呼吸、瓦尔萨尔瓦动作、握力、卧位站立、斯特鲁普和汗液测试。
APS 组的倾斜试验阳性，与对照组相比，与呼吸频率间隔的变化有关。与对照组相比，APS 病例的其他测试结果也明显改变。（仅对 14 例进行了汗液和斯特鲁普测试）。自主神经疾病与年龄、性别、疾病史、动脉或静脉血栓形成或抗体阳性无关；只有他们的凝血参数与自主神经功能障碍相关。
APS 中的自主神经功能障碍似乎与凝血参数有关。APS 患者应接受自主神经评估，以最大程度地降低致命性心律失常和猝死的风险。
