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Autonomic Dysfunction in Systemic Sclerosis:Sympathetic Overactivity and Instability
Am J Med 93:143-150, Dessein,P.H.,et al, 1992
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Article Abstract
Autonomic testing revealed AD in each patient,while symptoms were experienced by 33 of them.Findings on two of the three heart rate tests and both blood pressure tests were significantly impaired as compared with those in 25 matched control subjects.Mean resting plasma adrenaline levels were 18 times higher than in 10 matched controls(p<0.001).Plasma catecholamine(adrenaline,noradrenaline,and dopamine)concentrations and mean arterial blood pressures fluctuated inappropriately during standing and sustained handgrip in 28(82%)of the patients.The presence of headaches correlated significantly with sympathetic overactivity and instability(p< 0.050).Resting plasma adrenaline concentrations correlated inversely with disease duration(p<0.05).Significant suppression of sympathetic overactivity and increases in resting lower esophageal sphincter pressures were observed in seven patients treated with clonidine.AD is extremely common in SSc.It is characterized by parasympathetic impairment and marked sympathetic overactivity,particularly in early disease.The potential role of AD in the pathogenesis of SSc deserves further study.
 
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autonomic cardiovascular reflexes
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