Cardiovascular autonomic nervous system dysfunction in patients with rheumatoid arthritis and systemic lupus erythematosus

Louthrenoo, Worawit; Ruttanaumpawan, Pimon; Aramrattana, Apinun; Sukitawut, Waraporn

doi:10.1093/qjmed/92.2.97

Cited by 74 publications

(82 citation statements)

References 20 publications

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“…Several investigators assessed cardiovascular autonomic nerve function in RA patients and observed cardiovascular autonomic nervous system dysfunction [5][6][7][8] .Similar trends for greater fall of SBP in RA patients was noted by Louthreno et al 5 .and less rise of DBP was reported by Sandhu and Allen 6 whereas similar results in both parameters were also reported 2 .…”

Section: Discussionsupporting

confidence: 58%

“…In contrast Louthreno et al 5 found greater rise of DBP in response to sustained handgrip and also did not find any correlation between diminished blood pressure response and disease duration and between fall of SBP and orthostatic hypotension symptoms in RA patients. Sandhu & Allen 6 observed less fall of SBP in response to standing in patients with RA.…”

Section: Discussionmentioning

confidence: 73%

“…Immunological mechanism has been proposed for dysautonomia in RA 5,13 . Recently RA patients with autonomic dysfunction has been demonstrated with presence of autoantibody against nerve growth factor and cervical ganglion [13][14] .…”

Section: Discussionmentioning

confidence: 99%

“…The autonomic nervous system plays very important role in regulating cardiovascular homeostasis and RA may cause autonomic imbalance which is not well studied as well as presented conflicting results 5 . Higher sympathetic activity in RA was reported by some studies 5 whereas others found sympathetic dysfunction in RA 6 . Recently, orthostatic hypotension was found in 8% of RA patients 2 .…”

mentioning

confidence: 99%

“…Recently, orthostatic hypotension was found in 8% of RA patients 2 . Though, few studies investigated autonomic function in RA [5][6][7][8][9] , the effect of duration of RA on 10 with duration of disease from one to ten years were enrolled from the Rheumatology wing of the outpatient department of medicine of BSMMU, Dhaka. Age and BMI matched 30 apparently healthy sedentary females were control.…”

mentioning

confidence: 99%

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Relationship of Sympathetic Dysfunction with Disease Duration In Female Rheumatoid Arthritis Patients

Ferdousi

Jahan²,

Begum

2015

J Bangladesh Soc Physiol

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Background: Association of increased cardiovascular morbidity and higher sympathetic activity in patients with Rheumatoid arthritis (RA) has been well recognized. Objective: To assess sympathetic nerve function status in Rheumatoid arthritis patients and its relationship to duration of the disease. Methods: This study was carried out in the dept of Physiology Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka during 2010.Sixty female RA patients aged 18-50 years with duration of disease from 1 to 10 years was selected from Rheumatology wing of Medicine OPD of BSMMU. Age and BMI matched female apparently healthy subjects were control. Sympathetic nerve function status was assessed by blood pressure response to orthostatic test and sustained hand grip isometric exercise test. In these two tests, fall in systolic blood pressure (SBP) and rise in diastolic blood pressure (DBP) respectively estimates sympathetic reactivity. For statistical analysis, unpaired students t test and pearsons correlation coefficient test was applied. Results: Mean values of fall of SBP was higher and rise of DBP was lower in RA patients compared to control which was statistically (P<0.001) significant. Again rise of DBP was negatively and fall of SBP was positively correlated with duration of the disease and the relationships were statistically highly significant (p<0.01). Conclusion: The results conclude that sympathetic reflex response was reduced in RA which was deteriorated with duration of disease.

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Relationship of Sympathetic Dysfunction with Disease Duration In Female Rheumatoid Arthritis Patients

Ferdousi

Jahan²,

Begum

2015

J Bangladesh Soc Physiol

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Significance of Chronic Tachycardia in Systemic Lupus Erythematosus

Utset

Ward

Thompson

et al. 2013

Arthritis Care & Research

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Objective. A significant subset of systemic lupus erythematosus (SLE) patients exhibit chronic tachycardia (CT) of unknown significance. We postulated that CT is a marker of lupus activity and severity. Methods. A cross-sectional database at the University of Chicago recorded disease activity, damage, disease manifestations, pain, anxiety, and physical function (PF). CT was defined as a heart rate of >95 beats per minute in at least 3 out of 4 sequential visits. Demographic, disease-specific, and self-reported symptoms were compared between groups with and without tachycardia. Results. Of the 243 subjects analyzed, 14.8% had CT. On univariate analysis, CT was associated with younger age at the time of enrollment (P ‫؍‬ 0.004), number of hospitalizations adjusted for years of SLE (P ‫؍‬ 0.001), current prednisone dose (P < 0.0001), history of serositis (P ‫؍‬ 0.03), anxiety score (P ‫؍‬ 0.004), and poor PF (P ‫؍‬ 0.0017). All domains of the Short Form 36 (SF-36) health survey correlated strongly with CT, but on multivariate regression this correlation appeared to be driven by poor PF. On multivariate regression, the Systemic Lupus Erythematosus Disease Activity Index score (P ‫؍‬ 0.03), younger age (P ‫؍‬ 0.04), and poor PF by the SF-36 domain (P ‫؍‬ 0.006) were independently correlated with CT, and anxiety trait and hemoglobin both trended closely to significant association (P ‫؍‬ 0.08 for both). Conclusion. CT is prevalent in SLE and is a clinically relevant physical finding. It implies greater lupus activity and physical frailty. Univariate association with serositis raises the possibility of subclinical serositis or pancarditis. Further study to elucidate the cardiopulmonary status of SLE patients with unexplained CT is planned.

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