Impact of heart rate variability, a marker for cardiac health, on lupus disease activity

Thanou, Aikaterini; Stavrakis, Stavros; Dyer, John W.; Munroe, Melissa E.; James, Judith A.; Merrill, Joan T.

doi:10.1186/s13075-016-1087-x

Cited by 55 publications

(59 citation statements)

References 39 publications

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“…Their study confirmed the presence of autonomic disorders with respect to both HRV and heart rate turbulence parameters and the presence of diurnal disturbances of sympathetic-parasympathetic balance. Thanou et al 3 found potential relationships between HRV domains and disease activity measured by SLEDAI and BILAG (British Isles Lupus Assessment Group). They also reported correlated HRV changes (time-domain analysis and HF power) with disease flares.…”

Section: Discussionmentioning

confidence: 99%

“…HRV has been used as a predictor of cardiovascular disease in several high-risk situations. 3 Normal heart rate variation depends on the balance between sympathetic and parasympathetic systems. It is defined as the degree of fluctuation of the beat-to-beat differences in cardiac rhythm.…”

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confidence: 99%

“…There are reports suggesting that patients with SLE without clinically apparent cardiac symptoms have impaired autonomic function, primarily in the form of increased sympathetic and decreased parasympathetic activity. 3,8 On the other hand, in the pediatric population there is only one study that shows the autonomic impairment in SLE up to date. 9 In this study, we aimed to investigate autonomic system functions in juvenile SLE patients by using HRV.…”

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confidence: 99%

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Heart rate variability in juvenile systemic lupus erythematosus patients

Başaran¹,

Çetin²,

Aydın³

et al. 2019

Turk J Pediatr

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Although neurological involvement has been well recognized in patients with systemic lupus erythematosus (SLE), autonomic nervous system (ANS) involvement has rarely been studied, and has shown conflicting results. The aim of this study was to evaluate the ANS functions by using heart rate variability (HRV) in juvenile patients with SLE. Sixteen juvenile-onset SLE patients and 16 healthy controls were enrolled in the study. All participants underwent 24-hour Holter electrocardiogram monitoring and HRV indices were assessed. The SLE disease activity index (SLEDAI) score was used to assess the disease activity. We analyzed the correlation between disease duration, the SLEDAI score, and the HRV domains. Overall HRV was diminished in patients with SLE compared to controls. There were negative correlations between day and night RMSSD (root-mean-square of the successive normal sinus NN interval differences) and PNN50 (percentage of successive normal sinus NN intervals >50 ms) values, and SLEDAI (r=-0.588 p=0.017; r=-0.607 p= 0.013; r=-0.498 p=0.049; r=-0.597 p=0.015, respectively). There were positive correlations between both day and night LF/HF values and SLEDAI (r=0.766 p=0.001; r=0.635 p=0.008, respectively). The results suggest that autonomic dysfunction exists in juvenile patients with SLE. As these children are at increased risk for cardiovascular disease, they need to be assessed for the development of autonomic dysfunction.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Heart rate variability in juvenile systemic lupus erythematosus patients

Başaran¹,

Çetin²,

Aydın³

et al. 2019

Turk J Pediatr

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“…The prevalence of autonomic dysfunction ranged widely from 6 to 93% in patients with SLE [113,130]. Autonomic dysfunction in SLE is often asymptomatic and is not associated with disease activity, disease damage, and serological markers [131,134]. The findings of most of the studies reviewed supported sympathetic nervous system predominance or parasympathetic nervous system dysregulation, as reflected by decreased HRV in patients with SLE [135].…”

Section: Autonomic Dysfunction In Systemic Lupus Erythematosusmentioning

confidence: 96%

Ganglionic Acetylcholine Receptor Antibodies and Autonomic Dysfunction in Autoimmune Rheumatic Diseases

Imamura

Mukaino

Takamatsu

et al. 2020

IJMS

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Autonomic neuropathy has been reported in autoimmune rheumatic diseases (ARD) including Sjögren’s syndrome, systemic sclerosis, rheumatoid arthritis, and systemic lupus erythematosus. However, the pathophysiological mechanism underlying autonomic dysfunction remains unknown to researchers. On the other hand, autoimmune autonomic ganglionopathy (AAG) is an acquired immune-mediated disorder, which causes dysautonomia that is mediated by autoantibodies against ganglionic acetylcholine receptors (gAChRs). The purpose of this review was to describe the characteristics of autonomic disturbance through previous case reports and the functional tests used in these studies and address the importance of anti-gAChR antibodies. We have established luciferase immunoprecipitation systems to detect antibodies against gAChR in the past and determined the prevalence of gAChR antibodies in various autoimmune diseases including AAG and rheumatic diseases. Autonomic dysfunction, which affects lower parasympathetic and higher sympathetic activity, is usually observed in ARD. The anti-gAChR antibodies may play a crucial role in autonomic dysfunction observed in ARD. Further studies are necessary to determine whether anti-gAChR antibody levels are correlated with the severity of autonomic dysfunction in ARD.

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“…Controlled asthma is associated with enhanced parasympathetic modulation and higher HRV compared to uncontrolled asthma (Lutfi, 2015). Studies on systemic lupus erythematosus (SLE) patients reported a correlation of HRV with the cytokine levels and the clinical status (Thanou et al, 2016;Matusik et al, 2018). Similarly, HRV has been found to predict response to therapy in rheumatoid arthritis (RA) (Holman and Ng, 2008).…”

Section: Variability Characterizes the Biological Systems And Heart mentioning

confidence: 99%

A Personalized Signature and Chronotherapy-Based Platform for Improving the Efficacy of Sepsis Treatment

Kenig

Ilan

2019

Front. Physiol.

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Sepsis remains a major therapeutic challenge and is associated with a high rate of morbidity and mortality. It is a dynamic condition in which multiple parameters change over time, rendering it difficult to overcome the various injurious responses, which worsen the prognosis in these patients. The prognosis of sepsis is associated with a disbalance of compensatory responses to infectious triggers, part of which can be deleterious. Marked inter-and intra-patient variability characterizes the mechanisms that underlie sepsis progression and determine the response to therapy. In this paper, we review some of the data on the use of chronopharmacological approaches for the treatment of patients with sepsis and discuss the role of the autonomic nervous system in the mechanisms associated with immune response and chronotherapy in these patients. We describe the implementation of an individualized platform that is based on the personalized autonomic nervous system, immune, and chronobiologyderived parameters for generating a patient-tailored therapeutic regimen. The notion of overcoming the deleterious compensatory response in a highly dynamic system in sepsis is presented to ensure an improved response to current therapies.

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Impact of heart rate variability, a marker for cardiac health, on lupus disease activity

Abstract: Background: Decreased heart rate variability (HRV) is associated with adverse outcomes in cardiovascular diseases and has been observed in patients with systemic lupus erythematosus (SLE). We examined the relationship of HRV with SLE disease activity and selected cytokine pathways.

Cited by 55 publications

References 39 publications

Heart rate variability in juvenile systemic lupus erythematosus patients

Heart rate variability in juvenile systemic lupus erythematosus patients

Ganglionic Acetylcholine Receptor Antibodies and Autonomic Dysfunction in Autoimmune Rheumatic Diseases

A Personalized Signature and Chronotherapy-Based Platform for Improving the Efficacy of Sepsis Treatment

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