The effects of age, seropositivity and disease duration on autonomic cardiovascular reflexes in patients with rheumatoid arthritis

2013

Background: Altered cardiovascular autonomic nerve function with impaired sympathovagal balance is found in rheumatoid arthritis (RA). Heart Rate Variability (HRV) analysis is an important tool for assessment of autonomic nerve activity. Objective: To assess cardiac autonomic nerve function status in patients with Rheumatoid arthritis (RA) by time domain measures of HRV. Methods: This cross sectional study was conducted in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from January to December 2010. Sixty female RA patients, age range 18-50 years were constituted study group enrolled from the Out-patient Rheumatology Wing, Department of Medicine, BSMMU. Age matched thirty apparently healthy females were studied as control. Time domain measures of Heart Rate Variability (HRV) such as Mean RR intervals, Mean HR, SDNN, RMSSD, NN50% and PNN 50% were recorded for 5 minutes by a Polygraph machine to observe cardiac autonomic nerve function activity. Data were analyzed by independent sample t test. Results: Mean R-R interval, SDNN, RMSSD, PNN50%, NN50% were significantly lower (p<0.001) but heart rate was significantly (P<0.001) higher in rheumatoid arthritis patients. Conclusion: Cardiac autonomic nerve function is impaired and characterized by reduced resting parasympathetic activity in female Rheumatoid Arthritis patients.

Section: Discussionsupporting

confidence: 81%

Heart Rate Variability in Patients with Rheumatoid Arthritis

Jahan

2013

“…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%

“…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: 88%

“…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%

See 1 more Smart Citation

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

Jahan²,

2015

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.

“…These suggestions like immune complex deposition, amyloid deposition, autoantibody production against nerve growth factor, cervical ganglia and vagus nerve may act as causative factors for this autonomic nerve function impairment in patients of the present series. 10,17,23 But all of them were not possible to study due to some limitation.…”

Section: Discussionmentioning

confidence: 99%

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

Jahan

2012

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.