Left atrial phasic function and heart rate variability in patients with systemic sclerosis: A new part of the old puzzle.

Authors:
Marijana Tadic
Marijana Tadic
University Clinical Hospital Center "Dr Dragisa Misovic"
Maja Zlatanovic
Maja Zlatanovic
University of Belgrade
Cesare Cuspidi
Cesare Cuspidi
University of Milano-Bicocca
Ana Stevanovic
Ana Stevanovic
LIMES Life and Medical Sciences Institute
Germany
Vesna Kocijancic
Vesna Kocijancic
Clinical Centre of Serbia dFaculty of Medicine
Italy
Sinisa U Pavlovic
Sinisa U Pavlovic
Clinical Center of Serbia
Nemanja Damjanov
Nemanja Damjanov
Institute of Rheumatology
Hungary
Vera Celic
Vera Celic
University Clinical Hospital Center "Dr Dragisa Misovic"

Echocardiography 2017 Oct 7;34(10):1447-1455. Epub 2017 Aug 7.

Cardiology Department, University Clinical Hospital Center "Dr. Dragisa Misovic - Dedinje,", Belgrade, Serbia.

Objective: We aimed to research left atrial (LA) phasic function and heart rate variability (HRV), as well as their relationship, in subjects with uncomplicated systemic sclerosis (SSc).

Methods: The investigation involved 44 SSc patients and 33 age-matched healthy controls. All participants underwent clinical examination, serological tests, 24-hours Holter monitoring, and echocardiographic examination including strain analysis.

Results: Maximum, minimum, and pre-A LA volumes and volume indices were higher in the SSc patients than in the controls. The total emptying fraction, the parameter of the LA reservoir function, as well as passive LA emptying fraction, which represents the LA conduit function, were significantly lower in the SSc patients compared to the controls. Active LA emptying fraction, the parameter of the LA booster pump function, was significantly higher in the SSc participants. There was no difference in LA reservoir function between the diffuse and the limited SSc form. LA conduit function was significantly decreased, whereas LA booster pump function was compensatory increased in the diffuse SSc form compared to the limited SSc form. Similar results were obtained by LA strain analysis. HRV indices were significantly decreased in the SSc patients. Modified Rodnan skin score, the parameter of skin involvement in SSc, and HRV indices correlated well with LA phasic function in SSc.

Conclusion: Left atrial (LA) phasic function, assessed by both volumetric and strain method, as well as cardiac autonomic nervous function is significantly deteriorated in SSc patients. Skin score and HRV indices correlate with LA phasic function parameters.

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http://dx.doi.org/10.1111/echo.13648DOI Listing
October 2017
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