Cardiac autonomic dysfunction in patients with systemic lupus, rheumatoid arthritis and sudden death risk

Milovanovic, Branislav; Stojanović, Ljiljana; Milićevik, Nebojsa; Vasic, K.; Bjelaković, Bojko; Krotin, Mirjana

doi:10.2298/sarh1002026m

Cited by 51 publications

(51 citation statements)

References 10 publications

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“…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.…”

Section: Discussionmentioning

confidence: 75%

“…22 Again, findings of Total power, HF and HF norm suggest lower parasympathetic activity and higher value of LF, LF norm and LF/HF indicate higher sympathetic activity in RA patients which are similar to those reported by some investigators of different countries. 11,15 In addition, higher sympathovagal balance shows dominance of sympathetic activity in this group of patients. Many explanations are suggested by different investigators for this involvement of autonomic nerve function activity in RA patients though the exact mechanisms are not yet clear.…”

Section: Discussionmentioning

confidence: 78%

“…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.…”

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confidence: 86%

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

Jahan

Begum

Ferdousi

2012

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 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.

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 78%

mentioning

confidence: 86%

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

Jahan

Begum

Ferdousi

2012

J Bangladesh Soc Physiol

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“…6 Cardiovascular autonomic neuropathy is a significant risk predictor for sudden cardiac death in autoimmune rheumatic diseases. 7 The improvement of autonomic dysfunction by TNFi etanercept therapy could be explained by the following theoretical evidence. Primarily, it has been proposed that the drug action might be through the inhibition of inflammatory cytokines.…”

Section: Discussionmentioning

confidence: 98%

Tumor necrosis factor-alpha blockade with etanercept improves autonomic dysfunction in rheumatoid arthritis

Syngle¹,

Ic²,

Krishan³

et al. 2016

IJRCI

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“…Cardiovascular autonomic neuropathy (CAN) is a significant risk predictor for sudden cardiac death in rheumatic diseases [Milovanovic et al 2010]. Interestingly, autonomic neuropathy is a third form of neurological involvement observed in these diseases [Toussirot et al 1999].…”

Section: Introductionmentioning

confidence: 99%

Disease-modifying antirheumatic drugs improve cardiovascular autonomic neuropathy in psoriatic arthritis

Syngle¹,

Krishan

et al. 2016

Therapeutic Advances in Musculoskeletal

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Background: Cardiovascular autonomic neuropathy (CAN) is a significant risk predictor for sudden cardiac death in autoimmune rheumatic diseases. As yet, there is no therapeutic treatment of CAN in psoriatic arthritis (PsA). Even now, the impact of the most commonly employed disease-modifying antirheumatic drug (DMARD) therapy on CAN in PsA is not known. Hence, we investigated the impact of DMARDs on CAN in PsA. Methods: In this prospective, cross-sectional study, 20 patients of PsA and 20 ageand sex-matched healthy controls were recruited. CAN was diagnosed by applying the five cardiovascular reflex tests according to Ewing. Parasympathetic dysfunction was established by performing three tests: heart-rate response to deep breathing, standing, and Valsalva tests. Sympathetic dysfunction was examined by applying two tests: blood pressure response to standing, and handgrip tests. Disease severity was assessed by the 28-joint-count disease activity score (DAS-28) and the disease activity score in psoriatic arthritis (DAPSA). Results: Cardiovascular reflex tests were impaired significantly among the PsA patients compared with well-matched healthy subjects (p < 0.05). Parasympathetic dysfunction was more prominent than sympathetic dysfunction. After 12 weeks treatment, parasympathetic dysfunction (heart rate response to deep breath and standing) significantly (p < 0.05) improved in patients with PsA, while there was no significant improvement in sympathetic function. Conclusion: These study results suggests parasympathetic autonomic dysfunction is more prominent than sympathetic dysfunction in PsA. Synthetic DMARDs improved parasympathetic dysfunction in PsA.

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Cardiac autonomic dysfunction in patients with systemic lupus, rheumatoid arthritis and sudden death risk

Abstract: SLE and RA are associated with severe autonomic dysfunction and the presence of significant risk predictors related to the onset of sudden cardiac death.

Cited by 51 publications

References 10 publications

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

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

Tumor necrosis factor-alpha blockade with etanercept improves autonomic dysfunction in rheumatoid arthritis

Disease-modifying antirheumatic drugs improve cardiovascular autonomic neuropathy in psoriatic arthritis

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