Heart rate variability and cardiac autonomic function in systemic lupus erythematosus

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.