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?
(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...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-12-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/12/24/7736 |
| _version_ | 1797380540076130304 |
|---|---|
| author | Elena Esmeralda Saramet Cristina Pomȋrleanu Alexandra Maştaleru Andra Oancea Doina-Clementina Cojocaru Mara Russu Robert Daniel Negru Codrina Ancuța |
| author_facet | Elena Esmeralda Saramet Cristina Pomȋrleanu Alexandra Maştaleru Andra Oancea Doina-Clementina Cojocaru Mara Russu Robert Daniel Negru Codrina Ancuța |
| author_sort | Elena Esmeralda Saramet |
| collection | DOAJ |
| description | (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. |
| first_indexed | 2024-03-08T20:38:46Z |
| format | Article |
| id | doaj.art-51ad57ca0a6442b0a5b6dea76cdf47db |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-08T20:38:46Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-51ad57ca0a6442b0a5b6dea76cdf47db2023-12-22T14:17:36ZengMDPI AGJournal of Clinical Medicine2077-03832023-12-011224773610.3390/jcm12247736Autonomic 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?Elena Esmeralda Saramet0Cristina Pomȋrleanu1Alexandra Maştaleru2Andra Oancea3Doina-Clementina Cojocaru4Mara Russu5Robert Daniel Negru6Codrina Ancuța7“Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iași, RomaniaDepartment of Medical Specialties II, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaClinical Rehabilitation Hospital, 700661 Iasi, RomaniaClinical Rehabilitation Hospital, 700661 Iasi, RomaniaClinical Rehabilitation Hospital, 700661 Iasi, Romania“Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iași, RomaniaClinical Rehabilitation Hospital, 700661 Iasi, RomaniaDepartment of Medical Specialties II, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania(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.https://www.mdpi.com/2077-0383/12/24/7736rheumatoid arthritisheart rate variabilityautonomic imbalancearrhythmic risk |
| spellingShingle | Elena Esmeralda Saramet Cristina Pomȋrleanu Alexandra Maştaleru Andra Oancea Doina-Clementina Cojocaru Mara Russu Robert Daniel Negru Codrina Ancuța 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? Journal of Clinical Medicine rheumatoid arthritis heart rate variability autonomic imbalance arrhythmic risk |
| title | 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? |
| title_full | 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? |
| title_fullStr | 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? |
| title_full_unstemmed | 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? |
| title_short | 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? |
| title_sort | 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 |
| topic | rheumatoid arthritis heart rate variability autonomic imbalance arrhythmic risk |
| url | https://www.mdpi.com/2077-0383/12/24/7736 |
| work_keys_str_mv | AT elenaesmeraldasaramet autonomicdysfunctionandcardiovascularriskinpatientswithrheumatoidarthritiscanheartratevariabilityanalysiscontributetoabetterevaluationofthecardiovascularprofileofapatient AT cristinapomirleanu autonomicdysfunctionandcardiovascularriskinpatientswithrheumatoidarthritiscanheartratevariabilityanalysiscontributetoabetterevaluationofthecardiovascularprofileofapatient AT alexandramastaleru autonomicdysfunctionandcardiovascularriskinpatientswithrheumatoidarthritiscanheartratevariabilityanalysiscontributetoabetterevaluationofthecardiovascularprofileofapatient AT andraoancea autonomicdysfunctionandcardiovascularriskinpatientswithrheumatoidarthritiscanheartratevariabilityanalysiscontributetoabetterevaluationofthecardiovascularprofileofapatient AT doinaclementinacojocaru autonomicdysfunctionandcardiovascularriskinpatientswithrheumatoidarthritiscanheartratevariabilityanalysiscontributetoabetterevaluationofthecardiovascularprofileofapatient AT mararussu autonomicdysfunctionandcardiovascularriskinpatientswithrheumatoidarthritiscanheartratevariabilityanalysiscontributetoabetterevaluationofthecardiovascularprofileofapatient AT robertdanielnegru autonomicdysfunctionandcardiovascularriskinpatientswithrheumatoidarthritiscanheartratevariabilityanalysiscontributetoabetterevaluationofthecardiovascularprofileofapatient AT codrinaancuta autonomicdysfunctionandcardiovascularriskinpatientswithrheumatoidarthritiscanheartratevariabilityanalysiscontributetoabetterevaluationofthecardiovascularprofileofapatient |