Autonomic impairment in rheumatoid arthritis

Show simple item record Janse van Rensburg, Dina Christina Ker, James A. Grant, C.C. (Catharina Cornelia) Fletcher, Lizelle 2012-12-12T11:19:47Z 2012-12-12T11:19:47Z 2012-08
dc.description.abstract AIM: To determine if there is a difference between autonomic cardiac control as measured by heart rate variability (HRV) in women with rheumatoid arthritis (RA) compared to a healthy control group. METHODS: The RA group (45) and control group (39) were matched for age and body mass index (BMI). Three techniques were used: time domain, frequency domain and Poincare` plot analysis. All possible confounding factors were excluded and the test environment strictly regulated. RESULTS: Basal heart rate was significantly higher in the RA patients. In the supine position significant differences existed between RA patients and controls (P 0.01). Indicators of parasympathetic activity showed significantly lower variation in the RA group (root mean square of the standard deviation [RMSSD] = 14.70, percentage of successive normal-to-normal interval differences larger than 50 ms [pNN50] = 0.50, standard deviation [SD]1 = 10.50, high frequency [HF] (ms2) = 31) compared to controls (RMSSD = 29.40, pNN50 = 7.8, SD1 = 20.9, HF (ms2) = 141.00). Indicators of sympathetic variation were also significantly lower in RA patients (SD2 = 36.70, low frequency [LF] (ms2) = 65) compared to controls (SD2 = 49.50, LF (ms2) = 175). In the standing position eight variables indicated autonomic impairment by significant differences (P 0.01) between the groups. The response of the RA group to an orthostatic stressor showed less vagal withdrawal, (P-values for RMSSD = 0.038, pNN50 = 0.022, SD1 = 0.043 and HF [ms2] = 0.008 respectively); and lower sympathetic response (P-values for SD2 = 0.001 and LF [ms2] < 0.001) when compared to controls. CONCLUSIONS: An inability of the autonomic nervous system to efficiently compensate for internal and external environmental changes may predispose RA patients to arrhythmias, thereby increasing cardiovascular mortality. All three methods used showed the same outcome, implying decreased HRV and thus an increased risk for arrhythmias in RA patients. Evaluating the autonomic nervous system might be critical in planning management of RA patients. en_US
dc.description.uri en_US
dc.identifier.citation Janse van Rensburg, DC, Ker, JA, Grant, CC & Fletcher, L 2012, 'Autonomic impairment in rheumatoid arthritis', International Journal of Rheumatic Diseases, vol. 15, no. 4, pp. 419-426, doi: 10.1111/j.1756-185X.2012.01730.x en_US
dc.identifier.issn 1756-1841 (print)
dc.identifier.issn 1756-185X (online)
dc.identifier.other 10.1111/j.1756-185X.2012.01730.x.
dc.language.iso en en_US
dc.publisher Blackwell Publishing en_US
dc.rights © 2012 The Authors, Asia Pacific League of Associations for Rheumatology and Blackwell Publishing Asia Pty Ltd. This is a preprint of an article published in International Journal of Rheumatic Diseases available online at en_US
dc.subject Autonomic nervous system dysfunction/impairment en_US
dc.subject Heart rate variability (HRV) en_US
dc.subject Rheumatoid arthritis (RA) en_US
dc.title Autonomic impairment in rheumatoid arthritis en_US
dc.type Preprint Article en_US

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