To Evaluate Cardiac Autonomic Nervous System Functions in Patients With Rheumatoid Arthritis

Abstract

Aim: To evaluate cardiac autonomic nervous system functions in patients with rheumatoid arthritis.Material snd Methods: The present study was carried out on both males and females of mean age group 44+12 years to study autonomic functions in RA. All parameters were recorded and studied on 35 volunteers, out of which 25 were diagnosed with RA and 10 were healthy individuals which served as controls.The cardiac functions were evaluated by six non-invasive standardized tests consisting of 30:15 ratio, standing / lying ratio, expiration / inspiration ratio, valsalva ratio, blood pressure response to standing, blood pressure response to valsalva maneuver and hand grip test.The tests were carried out on patient (in and out door) in department of Medicine, at DMC & H by using cardiofax Machine (Medicarid systems).Details of history and examination were recorded on special proforma.Results: In the present study standing to lying ratio (p<0.001),Expiration to inspiration ratio (p<0.01) both indicative of parasympathetic function were significantly less in RA patients as compared to control indicating an impaired vagal function in study group.On the blood pressure response to standing, the decrease in diastolic blood pressure was significant (P<0.01) in study group as compared to control which is indicative of hypofunctional sympathetic ANS.Conclusions: There is cardiac autonomic nervous system dysfunction (both sympathetic and parasympathetic) in the patients with Rheumatoid arthritis when compared to control.Autonomic function tests can help in predicting cardio vascular risk in Rheumatoid Arthritis patients.