rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2025-3193VLAHOArpcardio-3234Research ArticleASSOCIATED PROBLEMS OF CARDIOLOGYСМЕЖНЫЕ ВОПРОСЫ КАРДИОЛОГИИHeart rate variability parameters in patients with systemic sclerosis: association with disease characteristics and therapyПараметры вариабельности сердечного ритма у больных системной склеродермией: взаимосвязь с характеристиками заболевания и проводимой терапиейhttps://orcid.org/0000-0002-4795-4229АветисянГ. Р.AvetisianG. R.

Аветисян Гоар Ромиковна 

Москва

Goar R. Avetisian 

Moscow 

avetisyan.gr@yandex.ruhttps://orcid.org/0000-0001-5610-4819АничковД. А.AnichkovD. A.

Аничков Дмитрий Александрович  

Москва

Dmitrii A. Anichkov 

Moscow 

https://orcid.org/0000-0002-7410-9784КлименкоА. А.KlimenkoA. A.

Клименко Алеся Александровна 

Москва

Alesya A. Klimenko 

Moscow 

https://orcid.org/0009-0002-9589-5873ДонцоваА. И.DontsovaA. I.

Донцова Анастасия Игоревна 

Москва

Anastasia I. Dontsova 

Moscow 

ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н. И. Пирогова» Минздрава РоссииРоссияPirogov Russian National Research Medical UniversityRussian FederationФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н. И. Пирогова» Минздрава России ; ГБУЗ «Городская клиническая больница № 1 им. Н. И. Пирогова» ДЗМРоссияPirogov Russian National Research Medical University ; Pirogov City Clinical Hospital №1Russian Federation202522082025213264274Copyright © Avetisian G.R., Anichkov D.A., Klimenko A.A., Dontsova A.I., 20252025Аветисян Г.Р., Аничков Д.А., Клименко А.А., Донцова А.И.Avetisian G.R., Anichkov D.A., Klimenko A.A., Dontsova A.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/3234

Aim. To study heart rate variability (HRV) parameters in patients with systemic sclerosis (SSc) and their relationship with disease characteristics and therapy.Material and methods. A study included 48 SSc patients and 43 healthy individuals. HRV was assessed using electrocardiography (ECG) data recorded at rest during quiet breathing (a 5-minute ECG fragment) and ambulatory 24-hour ECG monitoring.Results. According to 5-minute ECG recordings, in patients with SSc, an increase in heart rate (p=0.023) and changes in HRV frequency parameters were detected compared with the control group: a decrease in HFlog and HFn.u. (p=0.046 and p=0.027, respectively), an increase in LF (p=0.018) and the ratio LF/HF (p=0.016). According to ambulatory ECG monitoring data, patients with SSc have increased heart rate, decreased SDNNidx and pNN50 during the entire recording period and during the daytime, and a statistically significant decrease in most HRV parameters (meanNN, SDNN, SDNNidx, rMSSD and pNN50) at night. According to 5-minute ECG recordings, a relationship was found between heart rate (meanRR and meanHR) and the duration of Raynaud's syndrome (R=0.31, p=0.034; R=-0.30, p=0.043). In the presence of a history of heart damage in patients with SSc, according to ambulatory monitoring data, lower SDNNidxall, SDNNidxday, SDNNidxnight, pNN50night were noted, according to 5-minute ECG recordings — lower values of total power, LFmc2, LFlog, SD2. In the presence of lung damage, there is a higher heart rate according to meanRR, meanHR and meanNNday (according to 5-minute and ambulatory ECG recordings). Correlation between C-reactive protein (CRP) level of and SD2/SD1 were revealed according to 5-minute ECG recordings (R=-0.419, p=0.015), DFAα1 (R=-0.419, p=0.015). Patients with SSc taking calcium channel blockers (CCB) had higher values of HRV time parameters according to ambulatory ECG monitoring (p<0.05).Conclusion. SSc patients exhibited reduced frequency-domain, time-domain, and nonlinear HRV parameters in both short-term and 24-hour ECG recordings. A potentially unfavorable relationship was identified between nonlinear HRV parameters and C-reactive protein (CRP) levels, as well as correlations of heart rate (HR) with Raynaud’s syndrome duration, and HRV with lung and heart involvement. CCB therapy was associated with improved circadian rhythm of HRV.

Цель. Изучить показатели вариабельности сердечного ритма (ВСР) у больных системной склеродермией (ССД) и их взаимосвязь с характеристиками заболевания и проводимой терапией.Материал и методы. В исследование включены 48 больных ССД и 43 здоровых лица. Проводили определение ВСР по данным электрокардиограммы (ЭКГ), записанной в покое при спокойном дыхании (5-мин фрагмент) и по данным суточного мониторирования ЭКГ (амбулаторно).Результаты. По данным 5-мин записей ЭКГ у больных ССД по сравнению с контрольной группой выявлены повышение частоты сердечных сокращений (ЧСС) (p=0,023) и изменения частотных параметров ВСР: снижение показателей HFlog и HFn.u. (p=0,046 и p=0,027 соответственно), повышение показателя LF (p=0,018) и отношения LF/HF (p=0,016). По данным суточного мониторирования ЭКГ у больных ССД наблюдаются повышение ЧСС, снижение SDNNidx и pNN50 за весь период записи и в дневное время, статистически значимое снижение большинства параметров ВСР (meanNN, SDNN, SDNNidx, rMSSD и pNN50) в ночное время. По данным 5-мин записей ЭКГ выявлена взаимосвязь между показателями ЧСС (meanRR и meanHR) и длительностью синдрома Рейно (R=0,31, p=0,034; R=-0,30, p=0,043). При наличии поражения сердца в анамнезе у больных ССД по данным суточного мониторирования отмечались более низкие показатели SDNNidxall, SDNNidxday, SDNNidxnight, pNN50night; по данным 5-мин записей ЭКГ — более низкие значения total power, LFмс2, LFlog, SD2. При наличии поражения легких отмечается более высокая ЧСС по показателям meanRR, meanHR и meanNNday (по данным 5-мин и суточных записей ЭКГ). Выявлены корреляции между уровнем С-реактивного белка и нелинейными параметрами ВСР (по данным 5-мин записей ЭКГ) SD2/SD1 (R=-0,419, p=0,015) и DFAα1 (R=-0,419, p=0,015). У больных ССД, принимающих блокаторы медленных кальциевых каналов, отмечаются более высокие значения временных параметров ВСР по данным суточного мониторирования ЭКГ (p<0,05).Заключение. У больных ССД наблюдаются снижение частотных, временных и нелинейных показателей ВСР по данным коротких и суточных записей ЭКГ. Выявлена потенциально неблагоприятная взаимосвязь нелинейных показателей ВСР и концентрации С-реактивного белка, а также корреляции ЧСС с длительностью синдрома Рейно и ВСР — с поражением легких и сердца. Терапия блокаторами медленных кальциевых каналов ассоциирована с улучшением циркадного ритма ВСР.

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The authors declare that there are no conflicts of interest present.