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Heart rate variability and cardiac autonomic function in systemic lupus erythematosus
Insights
Systemic Lupus Erythematosus (SLE) patients exhibit significantly impaired cardiac autonomic function, as measured by Heart Rate Variability (HRV). This suggests HRV is a valuable tool for detecting dysautonomia in SLE, even without overt symptoms.
Area of Science:
- Cardiology
- Rheumatology
- Autonomic Neuroscience
Background:
- Systemic Lupus Erythematosus (SLE) is an autoimmune disease that can affect multiple organ systems.
- Cardiac autonomic dysfunction, or dysautonomia, is a potential complication of SLE.
- Evaluating subclinical autonomic dysfunction is crucial for comprehensive patient management.
Purpose of the Study:
- To assess cardiac autonomic function in SLE patients without clinical signs of dysautonomia.
- To compare Heart Rate Variability (HRV) parameters between SLE patients and healthy controls.
- To determine the incidence of autonomic dysfunction in an SLE cohort using HRV analysis.
Main Methods:
- Utilized 24-hour ambulatory electrocardiography to record Heart Rate Variability (HRV).
- Analyzed time-domain (SDNN, pNN50) and frequency-domain (LF, HF) HRV parameters.
- Included 23 SLE patients (on corticosteroids, some with Ciclosporin A) and 14 healthy controls.
Main Results:
- SLE patients showed significantly lower HRV parameters compared to controls: SDNN (69.40 vs 127.72), pNN50 (16.44 vs 25.95), LF (8.34 vs 34.97), and HF (3.21 vs 12.18).
- High incidence of autonomic dysfunction detected in SLE patients: 78% for SDNN, 17% for pNN50, 91% for LF, and 56% for HF.
- These findings indicate widespread autonomic impairment in the studied SLE population.
Conclusions:
- Heart Rate Variability (HRV) analysis is a sensitive method for detecting cardiac autonomic dysfunction in SLE patients.
- Subclinical dysautonomia is prevalent in SLE, even in the absence of overt clinical symptoms.
- HRV monitoring may aid in early identification and management of autonomic complications in SLE.
Abstract:
The cardiac autonomic function was evaluated in 23 patients with Systemic Lupus Erythematosus (SLE) without clinical expression of dysautonomia and in 14 healthy volunteer subjects as a control group, by analysis of Heart Rate Variability (HRV) from 24h ambulatory electrocardiography. All the patients were taking corticosteroids and 10 of them also Ciclosporin A (CsA). The following parameters of HRV were performed: Time domain: standard deviation of the RR intervals average (SDNN) and percentage of RR adjacent intervals differing from each other more than 50 msec (pNN50). Frequency domain: low frequencies (LF) and high frequencies (HF). Significant lower values were detected in SLE patients vs controls: SDNN = 69.40 vs 127.72; pNN50 = 16.44 vs 25.95; LF = 8.34 vs 34.97; HF = 3.21 vs 12.18. The incidence of autonomic dysfunction in our SLE population evaluated by considering intervals of normality is approximately 78% for SDNN; 17% for pNN50; 91% for LF and, finally, 56% for HF. The analysis of HRV may be a valuable technique in the study of the incidence of dysautonomia for these patients.