ABSTRACT
Background: Sudden cardiac death in patients with Rheumatoid Arthritis has been attributed to the decreased vagal drive to the heart. Objective: To assess cardiac parasympathetic nerve function status in patients with Rheumatoid Arthritis (RA). Methods: This cross sectional study was conducted in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka from January to December 2010. Sixty female RA patients aged 18-50 years were included in the study group. They were enrolled from the Out Patient Department of Rheumatology Wing of the Department of Medicine, BSMMU, Dhaka. For comparison age matched thirty apparently healthy females were also studied as control. To assess parasympathetic nerve function status, all the subjects were examined by three noninvasive cardiovascular reflex tests such as heart rate response to valsalva maneuver (valsalva ratio), heart rate response to deep breathing and heart rate response to standing (30th :15th ratio). For statistical analysis independent sample t test was used. Results: Mean values of valsalva ratio, deep breathing test and 30th :15th ratio were significantly (p<0.001) lower in rheumatoid arthritis patients compared to those of healthy control. Conclusion: From this study it may be concluded that lower cardiac parasympathetic nerve activity characterized the autonomic nerve dysfunction in patients with Rheumatoid Arthritis.
ABSTRACT
Background: Women having regular ovarian cycle often experience premenstrual syndrome which may be associated with alterations of autonomic nerve function due to fluctuation of ovarian hormones during different phases of ovarian cycle. Objective: To observe the parasympathetic nerve function status and their relationships with ovarian hormones during different phases of ovarian cycle in healthy young women. Methods: This cross sectional study was carried out in the department of Physiology at BSMMU, Dhaka in 2007 on 30 eumenorrhogic healthy females aged 20 to 30 years. Serum estrogen and progesterone were measured by MEIA method and parasympathetic nerve functions were assessed by valsalva, deep breathing test and orthostatic test during follicular and luteal phases of ovarian cycle. Data were analyzed by paired student ‘t’ test, and Pearson’s Correlation coefficient test where applicable. Results: Mean resting HR,SBP,DBP and all measures of parasympathetic nerve function were similar in all phases of ovarian cycle. With serum estrogen level, deep breathing showed significant (p<0.05) positive correlation in follicular and luteal phase and valsalva showed significant positive correlation during luteal phase. Conclusion: The results this study suggest that estrogen has got positive influence on parasympathetic nerve function which support cardioprotective role of estrogen in premenopausal females.
ABSTRACT
Background: In postmenopausal women, the risk of cardiovascular diseases gradually increases and alterations in autonomic nerve functions commonly affect cardiac vagal control. Objective: To observe some aspects of parasympathetic nerve function status in apparently healthy post menopausal women. Method: This cross sectional study was carried out in the Department of Physiology Bangabandhu Sheikh Mujib Medical University. In this study, 30 postmenopausal women with age 45 to 60 years were included in group B (study group) and 30 premenopausal women aged 20 to 30 years were taken in group A (control group). They were further divided into group A1(menstrual),A2(follicular), A3(luteal) according to phases of menstrual cycle during which they were studied. Serum estrogen and progesterone levels were measured in postmenopausal women and also during follicular and luteal phases in premenopausal women and were estimated by MEIA technique. To assess parasympathetic nerve function status, three noninvasive cardiovascular reflex tests such as heart rate response to valsalva maneuver, heart rate response to deep breathing and heart rate response to standing were performed in all the subjects. Data were collected by recording ECG in resting conditions. For statistical analysis, unpaired t test and multiple regression analysis was used. Results: In postmenopausal women, serum estrogen and progesterone levels were significantly (p<0.001) lower compared to those of follicular and luteal phases of premenopausal women except progesterone level during follicular phase which was though lower but not statistically significant. Heart rate response to valsalva maneuver were almost similar in all the groups.Heart rate response to deep breathing and heart rate response to standing were significantly lower in group B than those of group A1, A2 and A3 respectively. On regression analysis parasympathetic nerve function in post postmenopausal women showed significant association with estrogen level. Conclusion: From this study it may be concluded that parasympathetic nerve function was lower in postmenopausal women, which may be related to decreased level of estrogen.