Schwemmer, S. and Beer, P. and Schoelmerich, J. and Fleck, M. and Straub, Rainer H. (2006) Cardiovascular and pupillary autonomic nervous dysfunction in patients with rheumatoid arthritis - a cross-sectional and longitudinal study. CLINICAL AND EXPERIMENTAL RHEUMATOLOGY, 24 (6). pp. 683-689. ISSN 0392-856X,
Full text not available from this repository. (Request a copy)Abstract
Objectives Patients with inflammatory diseases often demonstrate autonomic nervous dysfunction. This study was initiated to investigate cardiovascular (CAD) or pupillary autonomic dysfunction (PAD) in patients with rheumatoid arthritis (RA). Methods Between 1997 and 1998, 33 RA patients were examined for characteristics, and parameters of CAD and PAD. In a longitudinal part of this study, thirty patients have been re-evaluated 8.3 +/- 0.1 yr later (response rate = 91%). Results A total of 18 patients (60%) demonstrated either CAD or PAD. The prevalence of CAD was 6/30 (20%) and the prevalence of PAD was 15/30 (50%). Of all cardiovascular tests, the Ewing test demonstrated the worst results (13/30 patients were below the 5(th) percentile). Similar as in other diseases, several RA patients demonstrated autonomic nervous hyperreflexia with values above the 95(th) percentile (relative variation coefficient: 7/30; respiratory sinus arrhythmia measure: 12/30; Valsalva measure: 1/30; Ewing measure: 0/30; latency time of pupillary light reflex: 5/30; maximal pupillary area: 0/30). During the 8-year observation period, 4/30 RA patients died. Non-survivors as compared to survivors had increased heart rate variation in the respiratory arrhythmia test (p = 0.038, hyperreflexia) but largely decreased heart rate variation in the Ewing test (p = 0.009, hyporeflexia). Non-survivors as compared to survivors demonstrated more frequent pupillary autonomic dysfunction (100% vs. 42%, p = 0.035). Conclusions This study demonstrates that CAD and PAD were frequent in patients with RA. Patients with a poor test result in the Ewing test and PAD might have an increased risk of death. This study in RA patients demonstrates similar results as in patients with diabetes mellitus.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | SYSTEMIC-LUPUS-ERYTHEMATOSUS; PITUITARY-ADRENAL AXIS; SPECTRAL-ANALYSIS; NEUROPATHY; SCLEROSIS; ASSOCIATION; RESPONSES; DISEASE; TESTS; HYPERREFLEXIA; rheumatoid arthritis; cardiovascular autonomic dysfunction; pupillary autonomic dysfunction; mortality |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin I |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 19 Jan 2021 10:11 |
| Last Modified: | 19 Jan 2021 10:11 |
| URI: | https://pred.uni-regensburg.de/id/eprint/33792 |
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