Heart rate variability is related to disease activity and smoking in rheumatoid arthritis patients

Abstract

We investigated the heart rate variability (HRV) parameters in patients with rheumatoid arthritis (RA) and assessed their relationship with disease characteristics. Twenty-three female patients with RA [age 48+/-7 (mean+/-SD) years] free of cardiovascular diseases and 23 age- and gender-matched healthy controls were evaluated. After careful clinical examination, the following parameters were obtained after 24-h Holter recordings: average of all normal-to normal (NN) intervals over the entire 24-h ECG recording (meanNN, ms); the standard deviation for the time between NN complexes (SDNN, ms); the standard deviation of the average NN intervals for each 5-min period (SDANN, ms) and the square root of the mean-squared differences of successive NN intervals (rMSSD, ms). We also assessed quantitative parameters of the Poincaré plot: the standard deviation of the points perpendicular to the line-of-identity (SD1, ms); the standard deviation along the line-of-identity (SD2, ms) and their ratio (SD12). HRV parameters excluding SD2 were significantly lower in patients with RA, than in control group (p<0.05). Significant correlations of SDNN and SDANN with swollen joints count, Ritchie articular index, disease activity score (DAS) and disease duration were found. SDNN also correlated with leucocyte count and smoking. SD1 significantly correlated only with disease duration. Relationships between SDNN and smoking, swollen joints count and DAS were confirmed using multivariate analysis. Our data indicate that in patients with RA reduced HRV is independently associated with high disease activity and smoking. HRV assessment may be useful as a part of cardiovascular risk stratification in RA patients.

Power Spectral Analysis of Heart Rate Variability in Female Rheumatoid Arthritis Patients

“…13 Lower values of LF, HF, HF norm and LF norm were reported by various investigators of different countries in patients with rheumatoid arthritis in comparison with those of healthy control. 11,12,14,15 On the contrary, higher LF, LF/HF were observed by some investigators in patients with RA when compared with those of healthy control. 11,15 RA is one of the common systemic diseases in our country and is an important cause of disability, morbidity and mortality in the affected people.…”

“…11,12,14,15 and also from our country. [19][20][21] In this study, significantly higher resting pulse rate, diastolic blood pressure points comparatively higher sympathetic activity in RA which are similar to those findings reported by some researchers.…”

Comparison of Heart Rate Variability Adjusted for Age and Heart Rate in Women With Rheumatoid Arthritis and Women Without Rheumatic Diseases

“…увеличение ЧСС снижает парасимпатические показатели ВРС за счёт со-отношения частоты и показателей ВРС, фазных сме-щений вагусной импульсации при изменении дли-тельности сердечного цикла и модулирующего влияния симпатической активности на проявления дыхательной аритмии [23]. Ранее только в единичных исследованиях на небольших выборках продемонстрировано сни-жение показателей ВРС, полученных при анализе ко-ротких (5-минутных) и суточных записей ЭКГ, у боль-ных РА по сравнению с лицами, не страдающими рев-матическими заболеваниями [24][25][26][27][28].…”

PERSPEKTIVY OPREDELENIYa VARIABEL'NOSTI RITMA SERDTsA I DLITEL'NOSTI INTERVALA Q-T PRI REVMATOIDNOM ARTRITE I SISTEMNOY KRASNOY VOLChANKE

“…В единичных исследованиях продемонстрировано снижение ВРС у больных РА по сравнению с лицами, не страдающими РЗ (табл. 3) [126][127][128][129][130][131][132][133][134]. Полученные резуль-таты свидетельствуют о нарушении нейровегетативного автономного контроля деятельности сердца, а именно -о повышении влияния симпатического и снижении влияния парасимпатического отделов вегетативной нервной систе-мы на сердечную деятельность.…”

“…Выявлена связь между рентгенологической стадией РА, индексом HAQ и снижением показателей ВРС, отражающих ослабле-ние тонуса парасимпатического отдела АНС, что свиде-тельствует о повышении риска возникновения жизне-опасных желудочковых аритмий при более тяжелом те-чении болезни [131]. Отмечено снижение ВРС по мере увеличения активности РА [127,129,131]. Повышение риска ССО в данном случае может быть связано с вос-палительными изменениями в миокарде, сходными с таковыми при хроническом миокардите.…”