Autonomic Nervous System Dysfunction in Patients with Systemic Lupus Erythematosus / 대한류마티스학회지

OBJECTIVE: To investigate the prevalence of autonomic dysfunction and to evaluate the relationship between autonomic dysfunction and clinical parameters in patients with systemic lupus erythematosus (SLE). METHODS: Fifty-eight patients with SLE who met the American College of Rheumatology criteria for SLE and forty-five healthy controls were selected at our hospital. Cardiovascular autonomic nervous function (CAN) test, including heart rate variation in deep breathing, Valsalva maneuver and orthostatic change and blood pressure response to standing, handgrip, was done in patient group and controls. Erythrocyte sedimentation rate (ESR), antinuclear antibody, anti-dsDNA antibody, complete blood count, complement and disease duration of patients were retrospectively reviewed and disease activity was assessed by Mexican SLE disease activity index (MEX-SLEDAI). RESULTS: The frequency of parasympathetic damage was 51.7% in patients with SLE and 15.6% in controls. There was significant difference between 2 groups in heart rate variation in deep breathing. No significant correlations were observed between autonomic dysfunction and ESR, antinuclear antibody, anti-dsDNA antibody, thrombocytopenia, complement, disease duration of patients, but there was slightly positive correlation between number of abnormal parasympathetic function test and MEX-SLEDAI (r=0.32, p<0.05). CONCLUSION: The prevalence of autonomic dysfunction was high in SLE patients and there was high frequency in patients with high disease activity. Prospective studies are needed to determine the clinical significance of autonomic dysfunction in the morbidity and mortality of SLE.

Autonomic Nervous Dysfunction in Patients with Rheumatoid Arthritis / 대한류마티스학회지

OBJECTIVE: To investigate the frequency of autonomic nervous dysfunction and assess the factors associated with autonomic nervous dysfunction in patients with rheumatoid arthritis (RA). METHODS: Three battery of cardiovascular autonomic nervous function tests (CAN test);heart rate response to Valsalva maneuver,deep breathing and standing up,were performed in 68 patients who met the 1987 American Rheumatism Association revised criteria for RA and 58 healthy controls.Autonomic nervous dysfunction was defined as 2 of 3 CAN tests were abnormal. Clinical and radiographic variables such as age,sex,disease duration,erythrocyte sedimentaton rate (ESR)and bone destruction,were analyzed in patients with or without autonomic nervous dysfunction. RESULTS: In patients with RA,the frequency of autonomic nervous dysfunction was higher than healthy controls (50.8%in RA vs 15.5%in healthy controls,p<0.05).Age,sex,disease duration,ESR and bone destruction were not associated with autonomic nervous dysfunction in patients with RA CONCLUSIONS: This results suggest that autonomic nervous dysfunction may be a significant feature in patients with RA.