Cardiac Autonomic Function in Patients With Ankylosing Spondylitis

Abstract

Ankylosing spondylitis (AS) is a chronic inflammatory disease involing spine and enthesis. The primary aim of this study is to investigate the autonomic nervous system (ANS) function and the association between ANS and the functional status or disease activity in AS.The study included 42 AS patients, all fulfilling the modified New York criteria. All the patients are totally symptom free for ANS involvement and had normal neurological findings. These AS patients and 230 healthy volunteers receive analysis of 5 minutes heart rate variability (HRV) in lying posture. In addition, disease activity and functional status of these AS patients are assessed by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), and Bath Ankylosing Spondylitis Global Score (BAS-G).Both groups were age and sex-matched. Although the HRV analysis indicates that the peaks of total power (TP, 0–0.5 Hz) and high-frequency power (HF, 0.15–0.40 Hz) are similar in both groups, the activities of low-frequency power (LF, 0.04–0.15 Hz), LF in normalized units (LF%), and the ratio of LF to HF (LF/HF) in AS patients are obviously lower than healthy controls. The erythrocyte sedimentation rate and C-reactive protein revealed negative relationship with HF. The AS patients without peripheral joint disease have higher LF, TP, variance, LF%, and HF than the patients with peripheral joint disease. The AS patients without uvetis have higher HF than the patients with uvetis. The total scores of BASDI, BASFI, and BAS-G do not show any association to HRV parameters.AS patients have significantly abnormal cardiac autonomic regulation. This is closely related with some inflammatory activities. Reduced autonomic function may be one of the factors of high cardiovascular risk in AS patients.

Effect of Tai Chi Synergy T1 Exercise on Autonomic Function, Metabolism, and Physical Fitness of Healthy Individuals

“…LF% has been used as an indicator of sympathetic tone. The LF to HF ratio (LF/HF) resembles sympathovagal balance [ 8 , 9 ].…”

Causal Relationships Between Total Physical Activity and Ankylosing Spondylitis: A Mendelian Randomization Study

“…Elsewhere, it has been found that high disease activity of AS is related to low levels of PA in patients ( 34 ). The study has shown that spinal mobility, aerobic capacity, forced vital capacity, and cardiac autonomic regulation were significantly lower in patients with AS and were associated with disease activity ( 35 – 37 ). Enthesitis is related to deteriorated static foot posture in patients with AS ( 38 ).…”

Factors Associated with the Risk of Major Adverse Cardiovascular Events in Patients with Ankylosing Spondylitis: A Nationwide, Population-Based Case—Control Study

“…Firstly, the results of the retrospective case–control study had limited strength. The use of an administrative database could prevent us from obtaining information on important known risk factors, including disease activity, cardiac autonomic function [ 50 ], and lifestyle patterns such as smoking status, nutritional status, dietary habits, and stressful or psychiatric problems. Laboratory information involving plasma homocysteine [ 51 ] concentration was inaccessible.…”