Iloprost Treatment in Systemic Sclerosis – Effects on Autonomic Nervous System Assessed through Heart Rate Variability Parameters

Systemic sclerosis (SSc) is a disease of immune system associated with an imbalance of the vegetative system. The autonomic dysfunction can be evaluated using heart rate variability (HRV) parameters generated by short term electrocardiographic recordings or long term Holter recordings. Iloprost, a prostacyclin analog is used for the treatment of the Raynaud syndrome associated with SSc. Our study included 22 patients (mean age 55±11.74 years) with SSc treated with iloprost or iloprost and methotrexate and a control group of healthy adults (mean age 55.86±11.81 years). Both groups were submitted to a 24-hours Holter recording from which we extracted linear and non-linear parameters. Our study indicates that apart from the vasodilator effect, iloprost administration can be associated with a reduction of sympathetic activity and increased vagal tone. The iloprost effect on autonomic parameters suggests that its effect is more complex and can have beneficial consequences on both cardiovascular complications and mortality in patients with SSc.