Role of autonomic dysfunction in the regulation of myocardial blood flow in systemic sclerosis evaluated by cardiac magnetic resonance

Autor: Biagio Barbano, Andrea Fiorelli, Laura Romaggioli, Luigi Tubani, Marco Francone, Edoardo Rosato, Marta Liberatori, Nicola Galea, Antonietta Gigante, A. Romaniello, Federica Ciolina, Carlo Catalano, Cristian Borrazzo, Iacopo Carbone
Rok vydání: 2017
Předmět:
Adult
Male
medicine.medical_specialty
Heart Diseases
systemic sclerosis
autonomic dysfunction
Magnetic Resonance Imaging
Cine
Vasodilation
myocardial blood flow
Autonomic Nervous System
Asymptomatic
cardiac magnetic resonance
03 medical and health sciences
Young Adult
0302 clinical medicine
Rheumatology
Predictive Value of Tests
Risk Factors
Internal medicine
Coronary Circulation
medicine
Heart rate variability
Humans
030212 general & internal medicine
030203 arthritis & rheumatology
Scleroderma
Systemic
business.industry
Significant difference
Myocardial Perfusion Imaging
Heart
Blood flow
Middle Aged
cardiac Raynaud's phenomenon
Autonomic Nervous System Diseases
Case-Control Studies
Ambulatory
Cardiology
Female
medicine.symptom
Negative correlation
business
Cardiac magnetic resonance
circulatory and respiratory physiology
Zdroj: International journal of rheumatic diseases. 22(6)
ISSN: 1756-185X
Popis: Aim Autonomic dysfunction (AD) is an early feature of systemic sclerosis (SSc). A regular endothelial function is a prerequisite for normal response of the myocardial blood flow (MBF) to cold pressure test (CPT). The aim of the study was to evaluate the relation between MBF and AD at rest and after CPT in asymptomatic SSc patients. Methods Twenty SSc patients and 10 age-, sex- and body mass index-matched healthy controls underwent cardiac magnetic resonance at rest and after CPT. All subjects underwent 24 hours ambulatory 3-channel electrocardiogram Holter to evaluate AD by heart rate variability. Results We did not observe any significant difference in MBF (mL/g/min) at rest and after CPT between SSc patients and healthy controls. Delta of MBF (difference between MBF after CPT and rest MBF) was lower (P = 0.039) in SSc patients than healthy controls (0.28 [0.04-0.40] vs 0.33 [0.24-0.54]). The low frequency/high frequency (LF/HF) was higher (P = 0.002) in SSc patients than healthy controls (3 [1.7-6] vs 1.8 [1.1-2.8]). The high frequencies (HF), modulated mainly by paraympathetic system, was lower (P = 0.003) in SSc patients than healthy controls (30 [16-42] vs 36.5 [24-44]). Sympathetic hyperactivity, due to reduction of parasympathetic activity (HF), is present in SSc patients. A negative correlation was observed between Delta of MBF and LF/HF (r = -0.572, P = 0.0031). Conclusion AD, characterized by sympathovagal imbalance due to a reduced parasympathetic tone with high LF/HF ratio, could be responsible for the reduced myocardial vasodilatory response after CPT.
Databáze: OpenAIRE
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