The use of heart rate turbulence and heart rate variability in the assessment of autonomic regulation and circadian rhythm in patients with systemic lupus erythematosus without apparent heart disease

Lupus ◽  
2017 ◽  
Vol 27 (3) ◽  
pp. 436-444 ◽  
Author(s):  
A R Poliwczak ◽  
E Waszczykowska ◽  
B Dziankowska-Bartkowiak ◽  
M Koziróg ◽  
K Dworniak
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Lupus Erythematosus ◽  
High Frequency ◽  
Autonomic Function ◽  
Disease Duration ◽  
Control Group ◽  
Systemic Lupus ◽  
Heart Rate Turbulence

Background Systemic lupus erythematosus is a progressive autoimmune disease. There are reports suggesting that patients even without overt signs of cardiovascular complications have impaired autonomic function. The aim of this study was to assess autonomic function using heart rate turbulence and heart rate variability parameters indicated in 24-hour ECG Holter monitoring. Methods Twenty-six women with systemic lupus erythematosus and 30 healthy women were included. Twenty-four hour ambulatory ECG-Holter was performed in home conditions. The basic parameters of heart rate turbulence and heart rate variability were calculated. The analyses were performed for the entire day and separately for daytime activity and night time rest. Results There were no statistically significant differences in the basic anthropometric parameters. The mean duration of disease was 11.52 ± 7.42. There was a statistically significant higher turbulence onset (To) value in patients with systemic lupus erythematosus, median To = –0.17% (minimum –1.47, maximum 3.0) versus To = –1.36% (minimum –4.53, maximum –0.41), P < 0.001. There were no such differences for turbulence slope (Ts). In the 24-hour analysis almost all heart rate variability parameters were significantly lower in the systemic lupus erythematosus group than in the healthy controls, including SDANN and r-MSSD and p50NN. Concerning the morning activity and night resting periods, the results were similar as for the whole day. In the control group, higher values in morning activity were noted for parameters that characterise sympathetic activity, especially SDANN, and were significantly lower for parasympathetic parameters, including r-MSSD and p50NN, which prevailed at night. There were no statistically significant changes for systemic lupus erythematosus patients for p50NN and low and very low frequency. There was a positive correlation between disease duration and SDNN, R = 0.417; P < 0.05 and SDANN, R = 0.464; P < 0.05, a negative correlation between low/high frequency ratio and r-MSSD, R = –0.454; P < 0.05; p50NN, R = –0.435; P < 0.05 and high frequency, R = –0.478; P < 0.05. In contrast, there was no statistically significant correlation between heart rate turbulence and other variables evaluated, including disease duration and the type of autoantibodies. Conclusion: Our study confirms the presence of autonomic disorders with respect to both heart rate variability and heart rate turbulence parameters and the presence of diurnal disturbances of sympathetic–parasympathetic balance. Further studies are required.

Heart rate variability and cardiac autonomic function in systemic lupus erythematosus

Lupus ◽  
1996 ◽  
Vol 5 (1) ◽  
pp. 49-55 ◽  
Author(s):  
B. Lagana' ◽  
L. Tubani ◽  
N. Maffeo ◽  
C. Vella ◽  
E. Makk ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Lupus Erythematosus ◽  
Autonomic Function ◽  
Cardiac Autonomic Function ◽  
Systemic Lupus

Heart rate variability in patients with systemic lupus erythematosus: a systematic review and methodological considerations

Lupus ◽  
2018 ◽  
Vol 27 (8) ◽  
pp. 1225-1239 ◽  
Author(s):  
P S Matusik ◽  
P T Matusik ◽  
P K Stein
Keyword(s):  
Systematic Review ◽  
Systemic Lupus Erythematosus ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Disease Activity ◽  
Autonomic Dysfunction ◽  
Lupus Erythematosus ◽  
Controlled Vocabulary ◽  
Systemic Lupus ◽  
Heart Rate Turbulence

Aim The aim of this review was to summarize current knowledge about the scientific findings and potential clinical utility of heart rate variability measures in patients with systemic lupus erythematosus. Methods PubMed, Embase and Scopus databases were searched for the terms associated with systemic lupus erythematosus and heart rate variability, including controlled vocabulary, when appropriate. Articles published in English and available in full text were considered. Finally, 11 publications were selected, according to the systematic review protocol and were analyzed. Results In general, heart rate variability, measured in the time and frequency domains, was reported to be decreased in patients with systemic lupus erythematosus compared with controls. In some systemic lupus erythematosus studies, heart rate variability was found to correlate with inflammatory markers and albumin levels. A novel heart rate variability measure, heart rate turbulence onset, was shown to be increased, while heart rate turbulence slope was decreased in systemic lupus erythematosus patients. Reports of associations of changes in heart rate variability parameters with increasing systemic lupus erythematosus activity were inconsistent, showing decreasing heart rate variability or no relationship. However, the low/high frequency ratio was, in some studies, reported to increase with increasing disease activity or to be inversely correlated with albumin levels. Conclusions Patients with systemic lupus erythematosus have abnormal heart rate variability, which reflects cardiac autonomic dysfunction and may be related to inflammatory cytokines but not necessarily to disease activity. Thus measurement of heart rate variability could be a useful clinical tool for monitoring autonomic dysfunction in systemic lupus erythematosus, and may potentially provide prognostic information.

scholarly journals No Increase in Rate and Severity of Flares During Pregnancy and Post-Partum Period in Pregnant Patients with Systemic Lupus Erythematosus. A Sex, Age and Disease Duration Matched Controlled Study

2020 ◽  
Author(s):  
Worawit Louthrenoo ◽  
Thananant Trongkamolthum ◽  
Nuntana Kasitatnon ◽  
Antika Wongthanee
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Disease Duration ◽  
Post Partum ◽  
Age At Diagnosis ◽  
Controlled Study ◽  
Control Group ◽  
Systemic Lupus ◽  
Post Partum Period

Abstract Background: Flares in pregnant patients with systemic lupus erythematosus (SLE) have shown conflicting results. This study aimed to determine the disease activity, and rate and severity of flares in pregnant SLE patients compared with the non-pregnant SLE controls. Methods: The medical records of pregnant patients in the SLE cohort were identified. Controls were non-pregnant female SLE patients who were matched for age at diagnosis and disease duration prior to conception. Disease activity was determined by mSLEDAI-2K. The definition and severity of flares followed the SELANA-SLEDAI Flare Index. The disease activity was measured from 6 months prior to conception (-6M) until termination of pregnancy or delivery.Results: Ninety pregnancies occurred from 77 patients, of whom 36.67% had active disease at the time of conception. The pregnancy group was slightly, but significantly, younger than the control group at diagnosis (21.63 ± 5.89 years vs. 24.05 ± 7.27 years, p = 0.015). The SLE disease activity (mSLEDAI-2K) score was comparable in both groups from -6M to the post-partum period, with that in the control group being slightly but significantly higher than that in the pregnancy group at conception (3.57 ± 4.28 vs. 1.91 ± 3.44, p = 0.003). Of the 90 pregnancies, the overall incidence of flares in both groups was similar during pregnancy (39 vs. 26, p = 0.070). There also was no difference in the incidence of flare during each trimester, with 19 vs.7 flares among 90 pregnancies (p = 0.588) in the 1st, 12 vs. 12 among 82 (p = 0.682) in the 2nd, and 6 vs. 7 among 71 (p = 0.266) in the 3rd trimester. The incidence of flare during the post-partum period also was similar (42 vs. 30 flares among 90 pregnancies, p = 0.091). There was no difference in the severity of flare in each trimester, overall flare during pregnancy or post-partum flare. Conclusions: This study found no difference in flare rate or severity of flares between pregnant SLE patients and non-pregnant SLE controls, who were matched by sex, age at diagnosis and disease duration prior to pregnancy.

scholarly journals EVALUATION OF THE RELATIONSHIP BETWEEN IL-10, IL-17, IL-23 LEVELS AND DISEASE ACTIVITY OF SYSTEMIC LUPUS ERYTHEMATOSUS AND VITAMIN D STATUS

2021 ◽  
pp. 25-30
Author(s):  
Beyza Genç Çetin ◽  
Taşkın Şentük ◽  
Neriman Aydın
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Vitamin D ◽  
Patient Group ◽  
Lupus Erythematosus ◽  
Significant Relationship ◽  
Disease Duration ◽  
Control Group ◽  
Systemic Lupus ◽  
Vitamin D Levels ◽  
Significant Difference

Introduction: Systemic lupus erythematosus (SLE) is a multisystemic, autoimmune connective tissue disease characterized by a variable course and prognosis. We aimed to determine IL-10, IL-17 and IL-23 cytokines and vitamin D levels in SLE patients, which we think play role in the pathogenesis of the disease. Material and Method: Forty SLE patients and 20 healthy controls were included in our study. Levels of IL-10, IL-17 and IL-23 were measured by sandwich ELISA method. Quantitative data are expressed as mean ± standard deviation and median range (maximum-minimum) values. The data were analyzed at 95% confidence interval, and cases where the p value was less than 0.05 were considered statistically significant. Results: IL-10 and IL-17 levels of the control and patient groups were compared and no statistically significant difference was found (p=0.333, p=0.99). IL-23 levels of the patient group were found to be higher than the control group and were found to be statistically significant (p<0.001). No statistically significant relationship was found between disease duration or SLEDAI score and IL-23 levels (p=0.476). 25 (OH) vitamin D levels of the patient group were found to be lower than the control group and were statistically significant (p=0.003). No significant relationship was found between IL-10 and IL-17 levels and vitamin D. Significant relationship was found between IL-23 and vitamin D levels (p=0.019). Discussion: In our study, there was no significant difference between the groups in terms of IL-10 or IL-17, while IL-23 levels were found to be significantly higher in SLE patients. Vitamin D levels were found to be lower in the patient group with SLE compared to the control group, and a negative correlation was found between the disease duration and IL-23. Specific blocking of the IL-23 immune pathway can be an effective and safe treatment option in the treatment of SLE.

Can anticarbamylated protein antibodies be used to support the diagnosis of systemic lupus erythematosus?

2021 ◽  
Vol 15 (14) ◽  
pp. 1253-1260
Author(s):  
Bahar Özdemir ◽  
Abdulsamet Erden ◽  
Şükran Erten ◽  
Turan H Yeşil ◽  
Murat Alışık ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Diagnostic Criteria ◽  
Lupus Erythematosus ◽  
Disease Duration ◽  
Healthy Control Group ◽  
Control Group ◽  
Systemic Lupus ◽  
Median Disease Duration ◽  
Antibody Positivity ◽  
Healthy Control

Aim: Autoantibody development plays an important role in the pathogenesis of systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). In this study, we aimed to determine the diagnostic value of anticarbamylated protein antibody (anti-CarP) antibody in SLE and RA patients and its relationship with disease prognosis. Material & method: Fifty-seven SLE patients (F/M 50/7; median age 40.9 ± 13.7; median disease duration 2 years) who met the 2012 SLICC SLE diagnostic criteria were included in the study. A total of 46 RA patients selected according to the 2010 ACR/EULAR diagnostic criteria (F/M 38/8; median age 54.2 ± 12.4; median disease duration 2 years) were included. A total of 30 healthy individuals were selected as the control group. The anti-CarP antibody was studied by using human anticarbamylated protein antibody ELISA Kit (SunRedBio, Shanghai, China). Results: Anti-CarP antibody positivity was found to be 17.4% in RA patients (p < 0.001), 54.4% in SLE patients (p < 0.001) and 3.3% in the healthy control group. The anti-CarP antibody was determined to predict SLE patients with 54.4% sensitivity and 96.7% specificity compared with the healthy control group (area under the curve: 0.755; p < 0.001). Conclusion: Anti-CarP antibody positivity was significantly higher in the SLE patients compared with the healthy control and RA group. It has significant sensitivity and specificity in both SLE and RA patients compared with the healthy controls.

Heart rate variability in patients with systemic lupus erythematosus

Lupus ◽  
1996 ◽  
Vol 5 (1) ◽  
pp. 44-48 ◽  
Author(s):  
KS Stein ◽  
IC McFarlane ◽  
N. Goldberg ◽  
EM Ginzler
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Lupus Erythematosus ◽  
Systemic Lupus

scholarly journals Heart rate variability in juvenile systemic lupus erythematosus patients

2019 ◽  
Vol 61 (5) ◽  
pp. 733
Author(s):  
Özge Başaran ◽  
İbrahim İlker Çetin ◽  
Fatma Aydın ◽  
Nermin Uncu ◽  
Nilgün Çakar ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Juvenile Systemic Lupus Erythematosus

Deterioration of Heart Rate Recovery Index in Patients with Systemic Lupus Erythematosus

2010 ◽  
Vol 37 (12) ◽  
pp. 2511-2515 ◽  
Author(s):  
ORHAN DOGDU ◽  
MIKAIL YARLIOGLUES ◽  
MEHMET GUNGOR KAYA ◽  
IDRIS ARDIC ◽  
NILUFER OGUZHAN ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Heart Rate ◽  
Lupus Erythematosus ◽  
Heart Rate Recovery ◽  
Recovery Period ◽  
Exercise Stress ◽  
Control Group ◽  
Systemic Lupus ◽  
Metabolic Equivalents ◽  
Recovery Index

Objective.Systemic lupus erythematosus (SLE) is an autoimmune disorder resulting in multisystemic inflammatory damage. It is reported that cardiovascular diseases (CVD) are responsible for 20%–30% of deaths in patients with SLE. Heart rate recovery after exercise is a function of vagal reactivation, and its impairment is an independent prognostic indicator for cardiovascular and all-cause mortality. The aim of our study was to evaluate the heart rate recovery index in patients with SLE.Methods.The study population included 48 patients with SLE (35 women, mean age 46.3 ± 12.8 yrs, mean disease duration 6.0 ± 2.3 yrs) and 44 healthy controls (30 women, mean age 45.7 ± 12.9 yrs). Basal electrocardiography, echocardiography, and treadmill exercise testing were performed on all patients and controls. The heart rate recovery index was defined as the reduction in the heart rate from the rate at peak exercise to the rate at the first minute (HRR1), second minute (HRR2), third minute (HRR3), and fifth minute (HRR5) after stopping exercise stress testing.Results.There were significant differences in HRR1 and HRR2 indices between patients with SLE and the control group (24.1 ± 6.5 vs 33.3 ± 9.3; p < 0.001, and 44.6 ± 13.3 vs 53.7 ± 9.9; p < 0.001, respectively). Similarly, HRR3 and HRR5 indices of the recovery period were lower in patients with SLE, compared with indices in the control group (57.6 ± 13.0 vs 64.9 ± 11.7; p = 0.006, and 67.2 ± 12.3 vs 75.0 ± 15.4; p = 0.009, respectively). Effort capacity was markedly lower (9.0 ± 1.9 vs 11.1 ± 2.3 metabolic equivalents; p = 0.001, respectively) among the patients with SLE.Conclusion.The heart rate recovery index is deteriorated in patients with SLE. When the prognostic significance of the heart rate recovery index is considered, these results may contribute to explain the increased occurrence of cardiac death. It points to the importance of the heart rate recovery index in the identification of high-risk patients.

Sign in / Sign up

Export Citation Format

Share Document