Autonomic Dysfunction and Cardiovascular Risk in Patients with Rheumatoid Arthritis: Can Heart Rate Variability Analysis Contribute to a Better Evaluation of the Cardiovascular Profile of a Patient?

被引:2
作者
Saramet, Elena Esmeralda [1 ]
Pomirleanu, Cristina [2 ,3 ]
Mastaleru, Alexandra [3 ,4 ]
Oancea, Andra [3 ,4 ]
Cojocaru, Doina-Clementina [3 ,4 ]
Russu, Mara [1 ]
Negru, Robert Daniel [3 ,4 ]
Ancuta, Codrina [2 ,3 ]
机构
[1] Grigore T Popa Univ Med & Pharm, 16 Univ Str, Iasi 700115, Romania
[2] Grigore T Popa Univ Med & Pharm, Dept Med Specialties 2, Iasi 700115, Romania
[3] Clin Rehabil Hosp, Iasi 700661, Romania
[4] Grigore T Popa Univ Med & Pharm, Dept Med Specialties 1, Iasi 700115, Romania
关键词
rheumatoid arthritis; heart rate variability; autonomic imbalance; arrhythmic risk; C-REACTIVE PROTEIN; DISEASE-ACTIVITY; ANTIINFLAMMATORY PATHWAY; INDIAN PATIENTS; SYSTEMIC-LUPUS; QT INTERVAL; INFLAMMATION; ASSOCIATION; MORTALITY;
D O I
10.3390/jcm12247736
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
(1) Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease of autoimmune etiology. Increased scientific evidence suggests that immune-mediated inflammatory dis-eases are associated with autonomic nervous system (ANS) dysfunction. Studies proved that autonomic imbalance is correlated with RA evolution and may explain augmented cardiovascular pathology and mortality not attributable to classical risk factors. (2) Methods: 75 patients (25 males, 50 females) with RA were submitted to standard ECG recording and 24 h Holter monitoring. Twenty-five healthy patients were used as controls. Both time (SDNN, SDANN, SDANN Index, RRmed, rMSSD, and pNN50) and frequency domain (TP, VLF, HF, LF and LF/HF) heart rate variability (HRV) parameters were obtained. Parameters were compared to controls, and correlations with the QTc-interval and inflammatory status expressed through the C-reactive protein (CRP) were evaluated. (3) Results: In patients with a CRP > 5 mg/L, HRV parameters were lower compared to controls and to patients with a CRP <= 5 mg/L. All HRV parameters generated by Holter monitoring are negatively correlated with CRP levels and QTc values. The number of premature ventricular contractions (PVC) recorded is correlated with SDNN, SDANN, and LF/HF values. (4) Conclusions: Our study supports recent data suggesting that in RA there is an autonomic system dysfunction strongly connected with the inflammatory status of the patient. The autonomic dysfunction can contribute to the increased risk of cardiovascular death observed in patients with RA.
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页数:12
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