RESUMEN
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.
RESUMEN
Background: Altered cardiovascular autonomic nerve function with impaired sympathovagal balance is found in rheumatoid arthritis (RA). Heart Rate Variability (HRV) analysis is an important tool for assessment of autonomic nerve activity. Objective: To assess cardiac autonomic nerve function status in patients with Rheumatoid arthritis (RA) by time domain measures of HRV. Methods: This cross sectional study was conducted in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from January to December 2010. Sixty female RA patients, age range 18-50 years were constituted study group enrolled from the Out- patient Rheumatology Wing, Department of Medicine, BSMMU. Age matched thirty apparently healthy females were studied as control. Time domain measures of Heart Rate Variability (HRV) such as Mean RR intervals, Mean HR, SDNN, RMSSD, NN50% and PNN 50% were recorded for 5 minutes by a Polygraph machine to observe cardiac autonomic nerve function activity. Data were analyzed by independent sample t test. Results: Mean R-R interval, SDNN, RMSSD, PNN50%, NN50% were significantly lower (p<0.001) but heart rate was significantly (P<0.001) higher in rheumatoid arthritis patients. Conclusion: Cardiac autonomic nerve function is impaired and characterized by reduced resting parasympathetic activity in female Rheumatoid Arthritis patients.
RESUMEN
Background: Association of increased cardiovascular morbidity and higher sympathetic activity in patients with Rheumatoid arthritis (RA) has been recognized. Heart rate variability (HRV) is a useful measure to assess sympatho-vagal balance. Objective: To assess autonomic nerve function status in patients with Rheumatoid Arthritis (RA) by HRV analysis. 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. The HRV parameters were recorded by a Polyrite machine. For statistical analysis independent sample t test was used. Results: Mean resting pulse rate, diastolic blood pressure and mean systolic blood pressure were higher in rheumatoid arthritis patients in comparison to those of healthy control. Mean values of LF power, LF norm and LF/ HF were significantly higher (p<0.001) & TP and HF power, HF norm were significantly lower (p<0.001) in RA patients in comparison to those of healthy control. Conclusion: This study may conclude that sympathetic activity was higher with lower parasympathetic activity along with shifting of sympathovagal balance towards sympathetic predominance in patients with rheumatoid arthritis.