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

Abstract

Background: Association of increased cardiovascular morbidity and higher sympathetic activity in patients with Rheumatoid arthritis (RA) has been recognized. Heart rate variability (HRV) is a useful measure to assess sympatho-vagal balance. Objective: To assess autonomic nerve function status in patients with Rheumatoid Arthritis (RA) by HRV analysis. Methods: This cross sectional study was conducted in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka from January to December 2010. Sixty female RA patients aged 18-50 years were included in the study group. They were enrolled from the Out Patient Department of Rheumatology Wing of the Department of Medicine, BSMMU, Dhaka. For comparison age matched thirty apparently healthy females were also studied as control. The HRV parameters were recorded by a Polyrite machine. For statistical analysis independent sample t test was used. Results: Mean resting pulse rate, diastolic blood pressure and mean systolic blood pressure were higher in rheumatoid arthritis patients in comparison to those of healthy control. Mean values of LF power, LF norm and LF/ HF were significantly higher (p<0.001) & TP and HF power, HF norm were significantly lower (p<0.001) in RA patients in comparison to those of healthy control. Conclusion: This study may conclude that sympathetic activity was higher with lower parasympathetic activity along with shifting of sympathovagal balance towards sympathetic predominance in patients with rheumatoid arthritis.

Parasympathetic Nerve Function Status in Female with Rheumatoid Arthritis

“…6,[11][12] The results of the present study suggests attenuated cardiac vagal modulation in Rheumatoid arthritis and the above mentioned factors may be the consequence of inflammatory process of Rheumatoid arthritis. This finding is well correlated with those published in our previous report 23 …”

Autonomic Dysfunction in Major Depressive Disorder

“…Several other researchers observed similar trends but it was not statistically significant . 9,11,12 Opposite findings were also found in some literature 8,9,11 In this study no significant difference were observed in these parameters when compared between drug naïve and medicated MDD patients. This finding also suggest autonomic dysfunction in MDD patients remained unaffected by treatment with anti depressive drug.…”

“…The values of all the spectral parameters in healthy control were almost similar and also with findings, reported by various investigators. [11][12][13] In this study, significantly lower total power, HF power and HF norm and significantly higher LF norm in both drug naive and medicated depressed patients compared to control suggest lower parasympathetic and higher sympathetic drive and higher LH/HF ratio as index of sympathovagal imbalance in MDD patients. Similar observations were also made by some researchers 8,[16][17] .…”

Effect of Aging on Short Term Heart Rate Variability

“…[10][11][12][13][14][15][16][17][18][19] Different time domain components of HRV has been used as marker of overall cardiac autonomic activity. The task force guideline for HRV analysis have demonstrated the interpretation of these parameters to understand the status, behavior and the balance between sympathetic and parasympathetic function due to their continuous interaction.…”