Heart rate variability in patients with systemic lupus erythematosus

Stein, KS; McFarlane, IC; Goldberg, Nieca; Ginzler, EM

doi:10.1177/096120339600500109

Cited by 34 publications

(20 citation statements)

References 15 publications

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“…[26][27][28] As in our present observations in primary SS, this reduction in HR variability was not related to either disease duration or the use of corticosteroids or disease activity.…”

Section: Discussionsupporting

confidence: 72%

Spectral analysis of heart rate and blood pressure variability in primary Sjogren's syndrome

Barendregt

Tulen

Meiracker

et al. 2002

Annals of the Rheumatic Diseases

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Background: Autonomic dysfunction has been described in primary Sjögren's syndrome (SS). Objective: To investigate the circulatory autonomic regulation in patients with primary SS by power spectral analysis of heart rate and blood pressure variability. Methods: Forty three (42 female) patients with primary SS, mean age 52 years (range 23-80), with a mean disease duration of eight years (range 1-30) and 30 (15 female) healthy controls, mean age 43 years (range 21-68) were studied. In each patient blood pressure, heart rate, and respiration were measured continuously during supine rest and orthostatic challenge (60°head-up tilt). Power spectral analysis was performed to determine possible differences in short term sympathetic and parasympathetic autonomic regulation between patients and controls. Furthermore, spectral parameters were studied in relation to illness severity and disease duration of the patients with primary SS. Results: After controlling for differences in age, heart rate variability of the mid-frequency band and the variation coefficient of systolic blood pressure were significantly lower in patients with primary SS than in controls during supine rest. During 60°tilt patients with primary SS showed a significantly higher mean heart rate, mean systolic blood pressure, and variation coefficient of diastolic blood pressure, and a significantly lower baroreflex index than controls. After controlling for age, no differences were found either in heart rate variability, blood pressure results, and baroreflex sensitivity during supine rest and tilt between the subgroups divided according to disease duration, Schirmer test results, or between the subgroups with different fatigue scores. No differences were found in spectral data between the groups with and without positive antinuclear antibody serology. Conclusion: For the group no differences in sympathetic and parasympathetic cardiac control were seen between patients with primary SS and controls, as assessed by spectral techniques, although some cardiovascular differences were found, particularly during orthostatic challenge.

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“…[26][27][28] As in our present observations in primary SS, this reduction in HR variability was not related to either disease duration or the use of corticosteroids or disease activity.…”

Section: Discussionsupporting

confidence: 72%

Spectral analysis of heart rate and blood pressure variability in primary Sjogren's syndrome

Barendregt

Tulen

Meiracker

et al. 2002

Annals of the Rheumatic Diseases

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“…Accordingly, time domain and frequency domain analysis of instantaneous heart rate variability data provide several extremely useful indices of vagus nerve activity 70,71 . The relationship between decreased vagus nerve activity and increased pro-inflammatory responses has been studied in the context of several inflammatory diseases, including rheumatoid arthritis, systemic lupus erythematosus, sepsis, inflammatory bowel disease and sarcoidosis 73–80 .…”

Section: Therapeutic Implicationsmentioning

confidence: 99%

Reflex control of immunity

2009

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Inflammation can cause damage and even death. What controls this primitive and potentially lethal innate immune response to injury and infection? Molecular and neurophysiological studies during the past decade have revealed a pivotal answer: immunity is coordinated by neural circuits that operate reflexively The afferent arc of the reflex consists of nerves that sense injury and infection. This activates efferent neural circuits, including the cholinergic anti-inflammatory pathway that modulate immune responses and the progression of inflammatory diseases. It might be possible to develop therapeutics that target neural networks for the treatment of inflammatory disorders.

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“…Sudden death, increased morbidity and mortality following cardiac surgery in hostile or depressed patients, and increased death rates in patients with sepsis or organ failure are linked clinically to decreased vagus nerve activity (50)(51)(52)(53)(54). Clinical research implicates a significant correlation between depressed vagus nerve activity and increased morbidity and mortality in sepsis, rheumatoid arthritis, lupus, sarcoidosis, inflammatory bowel diseases, other diseases, and trauma (55)(56)(57)(58)(59)(60)(61)(62)(63). These studies demonstrate that decreased vagus nerve activity is associated with increased disease severity, but they have not established a causal relationship.…”

Section: Figurementioning

confidence: 99%

Physiology and immunology of the cholinergic antiinflammatory pathway

Tracey¹

2007

J. Clin. Invest.

1,387

1,131

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Cytokine production by the immune system contributes importantly to both health and disease. The nervous system, via an inflammatory reflex of the vagus nerve, can inhibit cytokine release and thereby prevent tissue injury and death. The efferent neural signaling pathway is termed the cholinergic antiinflammatory pathway. Cholinergic agonists inhibit cytokine synthesis and protect against cytokine-mediated diseases. Stimulation of the vagus nerve prevents the damaging effects of cytokine release in experimental sepsis, endotoxemia, ischemia/reperfusion injury, hemorrhagic shock, arthritis, and other inflammatory syndromes. Herein is a review of this physiological, functional anatomical mechanism for neurological regulation of cytokine-dependent disease that begins to define an immunological homunculus.

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Heart rate variability in patients with systemic lupus erythematosus

Cited by 34 publications

References 15 publications

Spectral analysis of heart rate and blood pressure variability in primary Sjogren's syndrome

Spectral analysis of heart rate and blood pressure variability in primary Sjogren's syndrome

Reflex control of immunity

Physiology and immunology of the cholinergic antiinflammatory pathway

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