Rheumatology Clinic, Internal Medicine Unit, AOE Cannizzaro, Catania, and Department of Clinical and Experimental Medicine, University of Catania, Italy.
Internal Medicine Unit, AOUP G. Rodolico-S. Marco, Catania, and Department of Clinical and Experimental Medicine, University of Catania, Italy.
Clin Exp Rheumatol. 2022 Oct;40(10):1964-1969. doi: 10.55563/clinexprheumatol/4j6028. Epub 2022 Jul 27.
Systemic sclerosis (SSc) is an autoimmune disease characterised by diffuse vasculopathy and fibrosis of skin and visceral organs. Moreover, autonomic dysfunction is also suggested as an important step during the multifactorial SSc pathogenesis. Baroreceptors are responsible for maintaining blood pressure by means of autonomic system modulation. Considering that autonomic dysfunction and arteriosclerosis can both reduce baroreceptor sensitivity (BRS), in this cross-sectional study we investigated BRS in SSc patients.
Twenty-one SSc patients (mean age 55±10 years, 18 females) and 147 age/sex-matched healthy controls were recruited for the study. BRS (ms/mmHg) was measured by a Finapres® Midi device (Finapres Medical Systems, Amsterdam, The Netherlands). Other parameters were measured: blood pressure, heart rate, heart rate variability triangular index (HRVI), intima-media thickness (IMT), carotid distensibility and pulse wave velocity (PWV).
BRS was significantly lower in SSc patients compared to controls (6.3±3.3 vs. 10.7±6.8 ms/mmHg; p=0.004). IMT was comparable between SSc and controls, whereas carotid distensibility was lower in SSc (20.1±7.6 vs. 26.6±13.3 KPa-1·10-3; p=0.02) and PWV higher in SSc (8.4±1.3 vs. 7.1±1.1 m/sec; p=0.01). Furthermore, HRVI was lower in SSc (4.5±2.1 vs. 7.5±2.8; p<0.001). BRS impairment was independent from age and carotid distensibility in SSc patients, suggesting that BRS dysfunction could be only partially a consequence of SSc vasculopathy.
BRS was reduced in SSc patients compared with healthy controls. This finding could represent a SSc-related alteration involving the autonomic system, besides being the mere consequence of sclerodermic vasculopathy.
系统性硬化症（SSc）是一种自身免疫性疾病，其特征为弥漫性血管病变和皮肤及内脏器官纤维化。此外，自主神经功能障碍也被认为是 SSc 多因素发病机制中的重要步骤。压力感受器通过自主神经系统调节来维持血压。考虑到自主神经功能障碍和动脉硬化均可降低压力感受器敏感性（BRS），在这项横断面研究中，我们研究了 SSc 患者的 BRS。
招募了 21 名 SSc 患者（平均年龄 55±10 岁，18 名女性）和 147 名年龄/性别匹配的健康对照者进行研究。使用 Finapres®Midi 设备（Finapres Medical Systems，阿姆斯特丹，荷兰）测量 BRS（ms/mmHg）。测量其他参数：血压、心率、心率变异性三角指数（HRVI）、内膜-中层厚度（IMT）、颈动脉顺应性和脉搏波速度（PWV）。
与对照组相比，SSc 患者的 BRS 显著降低（6.3±3.3 与 10.7±6.8 ms/mmHg；p=0.004）。SSc 与对照组的 IMT 相当，而 SSc 的颈动脉顺应性较低（20.1±7.6 与 26.6±13.3 KPa-1·10-3；p=0.02），PWV 较高（8.4±1.3 与 7.1±1.1 m/sec；p=0.01）。此外，SSc 患者的 HRVI 较低（4.5±2.1 与 7.5±2.8；p<0.001）。在 SSc 患者中，BRS 受损与年龄和颈动脉顺应性独立相关，提示 BRS 功能障碍可能仅仅是 SSc 血管病变的部分后果。
与健康对照组相比，SSc 患者的 BRS 降低。这一发现可能代表了一种与 SSc 相关的自主神经系统改变，而不仅仅是 SSc 血管病变的结果。
