{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T11:39:52Z","timestamp":1792755592986,"version":"4.5.0"},"reference-count":56,"publisher":"Canadian Science Publishing","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.nrcresearchpress.com\/page\/about\/CorporateTextAndDataMining"}],"funder":[{"name":"Science Fund of the Republic of Serbia.","award":["COVANSA"],"award-info":[{"award-number":["COVANSA"]}]},{"name":"Ministry of Education, Science, and Technological Development of the Republic of Serbia","award":["451-03-68\/2020-14\/200156"],"award-info":[{"award-number":["451-03-68\/2020-14\/200156"]}]}],"content-domain":{"domain":["cdnsciencepub.com"],"crossmark-restriction":false},"short-container-title":["Can. J. Physiol. Pharmacol."],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:p>Lyme disease, caused by Borrelia burgdorferi sensu lato, is a multisystem infectious disorder that may lead to persistent complications, including autonomic nervous system (ANS) dysfunction. Although postural orthostatic tachycardia syndrome (POTS) is frequently implicated in orthostatic intolerance in Lyme disease, the broader extent of autonomic impairment remains insufficiently characterized. The study aimed to evaluate ANS function in patients with late-stage Lyme disease using multiple diagnostic modalities and compare findings with healthy controls. This cross-sectional study included 324 participants: 233 patients with late-stage Lyme disease and 91 healthy controls. All participants underwent cardiovascular autonomic reflex testing (CART), beat-to-beat analysis of heart rate variability (HRV), baroreflex sensitivity and baroreflex effectiveness index assessment and blood pressure, 24 h Holter electrocardiography, and ambulatory blood pressure monitoring. Patients with Lyme disease demonstrated significantly higher rates of both sympathetic and parasympathetic dysfunction compared with controls ( p\u00a0&lt;\u00a00.05). Compared with healthy controls, patients with late-stage Lyme disease demonstrated significantly reduced HRV spectral parameters, including very low frequency, low frequency, and high frequency components ( p\u00a0&lt;\u00a00.05). Baroreflex sensitivity and baroreflex effectiveness index were also significantly reduced. Holter monitoring further revealed reduced time-domain HRV parameters and an elevated LF\/HF ratio ( p\u00a0&lt;\u00a00.05). These findings demonstrate substantial autonomic dysregulation in late-stage Lyme disease and highlight the importance of comprehensive autonomic evaluation in this population.<\/jats:p>","DOI":"10.1139\/cjpp-2026-0066","type":"journal-article","created":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T21:32:50Z","timestamp":1790458370000},"page":"1-10","update-policy":"https:\/\/doi.org\/10.1139\/csp-crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cardiovascular autonomic dysfunction in late-stage Lyme disease: a comprehensive autonomic assessment"],"prefix":"10.1139","volume":"104","author":[{"given":"Branislav","family":"Milovanovic","sequence":"first","affiliation":[{"name":"National Institute for Heart and Blood Vessels \"Dedinje\"","place":["Belgrade, Serbia"]},{"name":"University of Belgrade","place":["Belgrade, Serbia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikola","family":"Markovic","sequence":"additional","affiliation":[{"name":"National Institute for Heart and Blood Vessels \"Dedinje\"","place":["Belgrade, Serbia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masa","family":"Petrovic","sequence":"additional","affiliation":[{"name":"National Institute for Heart and Blood Vessels \"Dedinje\"","place":["Belgrade, Serbia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasko","family":"Zugic","sequence":"additional","affiliation":[{"name":"National Institute for Heart and Blood Vessels \"Dedinje\"","place":["Belgrade, Serbia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milijana","family":"Ostojic","sequence":"additional","affiliation":[{"name":"National Institute for Heart and Blood Vessels \"Dedinje\"","place":["Belgrade, Serbia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra","family":"Grbovic","sequence":"additional","affiliation":[{"name":"National Institute for Heart and Blood Vessels \"Dedinje\"","place":["Belgrade, Serbia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Smiljana","family":"Stojanovic","sequence":"additional","affiliation":[{"name":"National Institute for Heart and Blood Vessels \"Dedinje\"","place":["Belgrade, Serbia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dragisa","family":"Radovanovic","sequence":"additional","affiliation":[{"name":"National Institute for Heart and Blood Vessels \"Dedinje\"","place":["Belgrade, Serbia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0071-8376","authenticated-orcid":false,"given":"Vladimir","family":"Jakovljevic","sequence":"additional","affiliation":[{"name":"University of Kragujevac","place":["Kragujevac, Serbia"]},{"name":"University of Kragujevac","place":["Kragujevac, Serbia"]},{"name":"I.M. 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