Cardiovascular Autonomic Function Changes and Predictors During a 2-Year Physical Activity Program in Rheumatoid Arthritis: A PARA 2010 Substudy (original) (raw)
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Effect of exercise on cardiac autonomic function in females with rheumatoid arthritis
Clinical Rheumatology, 2012
The objective of this study is to evaluate the effect of exercise on cardiac autonomic function as measured by short-term heart rate variability (HRV) in females suffering from rheumatoid arthritis (RA). Females with confirmed RA were randomly assigned to an exercise group (RAE) and a sedentary group (RAC). RAE was required to train under supervision two to three times per week, for 3 months. Three techniques (time domain, frequency domain and Poincaré plot analyses) were used to measure HRV at baseline and study completion. At baseline, RAC (n018) had a significantly higher variability compared to RAE (n019) for most HRV indicators. At study completion, the variables showing significant changes (p00.01 to 0.05) favoured RAE in all instances. Wilcoxon signed rank tests were performed to assess changes within groups from start to end. RAE showed significant improvement for most of the standing variables, including measurements of combined autonomic influence, e.g. SDRR (p00.002) and variables indicating only vagal influence, e.g. pNN50 (p00.014). RAC mostly deteriorated with emphasis on variables measuring vagal influence (RMSSD, pNN50, SD1 and HF (ms 2 )). Study results indicated that 12 weeks of exercise intervention had a positive effect on cardiac autonomic function as measured by short-term HRV, in females with RA. Several of the standing variables indicated improved vagal influence on the heart rate. Exercise can thus potentially be used as an instrument to improve cardiac health in a patient group known for increased cardiac morbidity.
Asian Journal of Sports Medicine, 2020
Background: Cardiovascular autonomic dysfunction is one of the most common complications in rheumatoid arthritis (RA), which can be assessed by heart rate variability (HRV) analysis. Because the autonomic nervous system plays an important role in orchestrating the cardiovascular response to stressors, assessing HRV during exercise is critical. The Glittre Activities of Daily Living test (GA-T) was recently proposed as a multitask field test that requires the performance of the upper and lower limbs, both of which are affected in individuals with RA. Objectives: This study was conducted to evaluate autonomic impairment by HRV in women with RA using the GA-T and to correlate these changes with physical functioning and muscle strength. Methods: This cross-sectional study enrolled 20 women (median [interquartile range]: age 55 [47.5 - 68.8] years) with RA (time since diagnosis: 15 [6.50 - 23.5] years) who underwent HRV assessment during GA-T. They also underwent physical functioning ass...
BMC cardiovascular disorders, 2016
Patients with rheumatoid arthritis (RA) have an increased risk for cardiovascular disease (CVD) with poor parasympathetic function being implicated as an underlying factor. Factors related to parasympathetic function, commonly assessed by heart rate recovery (HRR) following maximal exercise, are currently not known in RA. We aimed to explore the association between HRR with CVD risk factors, inflammatory markers, and wellbeing in patients with RA. Ninety-six RA patients (54.4 ± 12.6 years, 68 % women) completed a treadmill exercise test, during which heart rate (HR) was monitored. HRR1 and HRR2 were defined as the absolute change from HR peak to HRR 1 min post HR peak and 2 min post HR peak, respectively. Cardiorespiratory fitness, CVD risk factors, and serological markers of inflammation were measured in all patients. The Framingham Risk Score (FRS) was used as an assessment of global risk for CVD events, and wellbeing was assessed by questionnaires. Mean HRR1 and HRR2 were 29.1 ± ...
Cardiovascular Autonomic Function in Individuals with Rheumatoid Arthritis
International Journal of Innovative Research in Medical Science
Rheumatoid arthritis is common inflammatory arthritis arising throughout the world. A chronic systemic inflammatory autoimmune disorder is known as Rheumatoid arthritis (RA). Principally it affects the joints and usually accompanied by one or more of extra-articular manifestations as rheumatoid nodules, neuropathy and norm chromic normocytic anemia. Rheumatoid arthritis can start at any age, but has maximum between 35 to 55 years of age. The prevalence of RA is about 1% worldwide whereas India is 0.9% with women suffering 3-5 times more than men. Sympathetic and parasympathetic involvement has described in primary and secondary vasculitis processes, as in systemic vasculitis processes like: SLE, RA. Peripheral nervous system is the main target in RA patients where as involvement of central nervous system (CNS) is rare. The aim of this study was to evaluate cardiac autonomic function in RA and compare with healthy individuals by using HRT analysis. Materials and Methods: A cross-sect...
Evaluation of cardiovascular autonomic function in patients with rheumatoid arthritis
Indian Journal of Clinical Anatomy and Physiology, 2022
Rheumatoid arthritis (RA) is a type of inflammatory arthritis that affects people all over the world. RA is a chronic systemic inflammatory autoimmune disease. It primarily affects the joints and is frequently accompanied by extra-articular symptoms such as rheumatoid nodules, neuropathy, and normochromic normocytic anaemia. Objectives- The aim of this study was to evaluate cardiac autonomic function in patients with rheumatoid arthritis and compare with healthy individuals. An observational, cross-sectional study was done between 50 having RA & 50 normal healthy subjects not on any medication, on both males & females between the age group of 30-60 years. Evaluation of autonomic nervous system was done with the help of non-invasive tests. Parasympathetic system was assessed by heart rate response to standing & heart rate response to lying down position. Sympathetic system was assessed by blood pressure response to standing, BP response to Valsalva Maneuverer & BP response to sustain...
Heart rate variability in patients with rheumatoid arthritis
Rheumatology International, 2003
Background: Altered cardiovascular autonomic nerve function with impaired sympathovagal balance is found in rheumatoid arthritis (RA). Heart Rate Variability (HRV) analysis is an important tool for assessment of autonomic nerve activity. Objective: To assess cardiac autonomic nerve function status in patients with Rheumatoid arthritis (RA) by time domain measures of HRV. Methods: This cross sectional study was conducted in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from January to December 2010. Sixty female RA patients, age range 18-50 years were constituted study group enrolled from the Outpatient Rheumatology Wing, Department of Medicine, BSMMU. Age matched thirty apparently healthy females were studied as control. Time domain measures of Heart Rate Variability (HRV) such as Mean RR intervals, Mean HR, SDNN, RMSSD, NN50% and PNN 50% were recorded for 5 minutes by a Polygraph machine to observe cardiac autonomic nerve function activity. Data were analyzed by independent sample t test. Results: Mean R-R interval, SDNN, RMSSD, PNN50%, NN50% were significantly lower (p<0.001) but heart rate was significantly (P<0.001) higher in rheumatoid arthritis patients. Conclusion: Cardiac autonomic nerve function is impaired and characterized by reduced resting parasympathetic activity in female Rheumatoid Arthritis patients.
Journal of internal medicine, 2017
To establish how guided physical activity in patients with rheumatoid arthritis (RA) without known cardiovascular disease affected vascular and cardiac function, and how these two entities were prospectively interconnected in this patient group. Prospective substudy of 29 participants in the Physical Activity in RA (PARA) 2010 trial. All subjects were examined at baseline, at year 1 and 2 with measures of pulse wave velocity and arterial augmentation index, as well as echocardiographic evaluation of diastolic parameters and ventricular-arterial coupling. Muscle strength and aerobic exercise capacity were assessed at baseline and yearly. All participants performed physiotherapist-guided aerobic and muscle strength exercise during two years and were reminded through SMS to report physical activity progress. This cohort of patients with RA exhibited increased vascular stiffness despite normal blood pressure. At baseline, lower muscle strength was associated with increased vascular stif...