Early diagnostics of cardiac autonomic dysfunction in patients with systemic sclerosis

Aim. To study the potential of early diagnostics of cardiac autonomic dysfunction (CAD) in patients with systemic sclerosis (SSc). Material and methods . The case-control study included 41 patients with SSc and 19 healthy individuals. Clinical tests (deep breathing test, blood pressure and heart rate (30:15) response to the orthostatic test) were performed, and patients were surveyed using the Composite Autonomic Symptom Score-31 (COMPASS-31) questionnaire. Results. The total COMPASS-31 score in patients with SSc was 24,6 [13,6; 37,6], in the control group — 13,8 [2,7; 32,8] (p=0,021). The combination of vasomotor and orthostatic disorders was observed more often in patients with SSc than in the control group — in 23 (56,1%) and 3 (15,8%) participants, respectively (OR — odds ratio) =6,82; 95% confidence interval (CI): 1,72-27,06; p=0,003. In patients with SSc, the 30:15 ratio (heart rate response to orthostatic test) was significantly lower than in the control group (p=0,001); pathological test results indicating CAD were more often observed in patients with SSc (OR=6,50; 95% CI: 1,26-33,58; p=0,016). A positive correlation was found between the total COMPASS-31 score and the duration of SSc from the disease onset, diagnosis, and the duration of Raynaud's syndrome (R=0,39, R=0,35, R=0,38, p<0,05). Conclusion . Patients with SSc show following early signs of CAD: vasomotor and orthostatic disorders are recorded 6,8 times more often according to the COMPASS-31 questionnaire, and pathological results of the 30:15 clinical test are detected 6,5 times more often.