Risk of subsequent atrial fibrillation in patients with myasthenia gravis

Liou, Yaw-Tzeng; Wei, James Cheng‐Chung; Hu, Kai-Chieh; Hung, Yao-Min; Chou, Mei‐Chia; Chang, Renin

doi:10.1097/md.0000000000026008

Cited by 2 publications

(1 citation statement)

References 33 publications

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“…The most life-threatening ADs are related to the cardiovascular system and include decreased heart rate variability (HRV), cardiac arrhythmias, and even atrial fibrillation [6,12,13].…”

Section: Introductionmentioning

confidence: 99%

Association of Cardiac Autonomic Responses with Clinical Outcomes of Myasthenia Gravis: Short-Term Analysis of the Heart-Rate and Blood Pressure Variability

Zawadka‐Kunikowska

Rzepiński²,

Tafil-Klawe

et al. 2022

JCM

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Introduction: The aim of the study was to assess cardiac and autonomic function in patients with myasthenia gravis (MG) and to explore its relationship with disease outcomes. Methods: Thirty-eight patients with an MG were enrolled (median age 40.5 years; median disease duration 5.5 years). Cardiovascular parameters, baroreflex sensitivity (BRS), spectral indices of short-term heart rate (HRV), and systolic blood pressure variability (SBPV) were compared with age- and gender-matched controls (n = 30). Cardiac autonomic function was assessed during the response to standing (tilt) and deep breathing tests (expiration/inspiration ratio-E/I). Results: HR and BP responses to the tilt test were similar in both groups. MG patients, as compared to controls, were characterized by altered SBPV at rest, significantly reduced HR response to the deep breathing test (p < 0.001), increased sympathovagal balance after tilt (delta LF/HF-RRI, p = 0.037), and lower values of BRS (p = 0.007) and hemodynamic parameters, i.e., cardiac index, index contractility, left ventricular work index, at rest and during tilt. There was no association between disease duration and autonomic parameters. Disease severity, as determined by MGFA (Myasthenia Gravis Foundation of America) corrected for age and sex, was an independent predictor of diminished vagal tone (E/I ratio) and increased sympathetic response to tilt (delta LF/HF-RRI) as measured with HRV. Lower BRS was associated with greater disease severity and older age. Hemodynamic parameters were predominantly predicted by age and sex. Conclusion: Our results confirm cardiac autonomic dysfunction among MG patients with predominant parasympathetic impairment. Clinicians should consider evaluation of autonomic balance in MG patients with, or at risk for, cardiovascular disease.

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“…The most life-threatening ADs are related to the cardiovascular system and include decreased heart rate variability (HRV), cardiac arrhythmias, and even atrial fibrillation [6,12,13].…”

Section: Introductionmentioning

confidence: 99%

Association of Cardiac Autonomic Responses with Clinical Outcomes of Myasthenia Gravis: Short-Term Analysis of the Heart-Rate and Blood Pressure Variability

Zawadka‐Kunikowska

Rzepiński²,

Tafil-Klawe

et al. 2022

JCM

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Comorbidity in myasthenia gravis: multicentric, hospital-based, and controlled study of 178 Italian patients

Di Stefano,

Iacono,

Militello

et al. 2024

Neurol Sci

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Background Myasthenia gravis (MG) is an autoimmune disorder with fluctuating weakness that causes significant disability and morbidity. Comorbidities may influence the course of MG, particularly in specific subgroups. The aim of this study is to investigate the frequency of comorbidities in MG patients compared to healthy controls (HC) and to evaluate their distribution according to age at disease onset, sex, and disease severity. Methods MG patients attending the University Hospital “Paolo Giaccone” in Palermo and “SS Annunziata” Hospital in Chieti were enrolled; HC were enrolled from the general population. Non-parametric statistics and logistic regression were used to assess the association of specific comorbidities according to age at disease onset, sex, disease subtypes, and severity of the disease. Results A total of 356 subjects were included in the study: 178 MG patients (46% F; median age 60 years [51–71]) and 178 sex- and age-matched HC (46% F, median age 59 years [50–66]). Overall, 86% of MG patients and 76% of HC suffered from comorbidities, and MG patients had a higher number of comorbidities compared to HC. Patients with late-onset suffered from more comorbidities than those with early-onset MG. Hypertension was more common in male patients with MG, while thymic hyperplasia, osteoporosis, and autoimmune diseases were more common in females. Respiratory disorders and thymoma were more common in patients with more severe disease (p < 0.05 for all comparisons). Conclusion MG patients, particularly those with late onset, showed a higher prevalence of comorbidities than HC. Assessment of comorbidities in MG is an essential issue to identify the appropriate treatment and achieve the best management.

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Risk of subsequent atrial fibrillation in patients with myasthenia gravis

Cited by 2 publications

References 33 publications

Association of Cardiac Autonomic Responses with Clinical Outcomes of Myasthenia Gravis: Short-Term Analysis of the Heart-Rate and Blood Pressure Variability

Association of Cardiac Autonomic Responses with Clinical Outcomes of Myasthenia Gravis: Short-Term Analysis of the Heart-Rate and Blood Pressure Variability

Comorbidity in myasthenia gravis: multicentric, hospital-based, and controlled study of 178 Italian patients

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