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Role of inflammation in the development of cardiac autonomic disfunction in patients with systemic lupus erythematosus

https://doi.org/10.14412/1995-4484-2008-484

Abstract

Objective. To evaluate role of inflammation in pathogenesis of cardiac autonomic dysfunction assessed by heart rate variability (HRV) analyses, in patients (pts) with systemic lupus erythematosus (SLE). Material and methods. 75 female pts with SLE aged before 55 years were included. Control group consisted of 32 healthy women of comparable age. Clinical symptoms, activity degree and main cardiovascular risk factors were assessed. Common carotid duplex scanning with measurement of intima-media thickness, echocardiography, 24 h ECG ambulatory recording with determination of time domain parameters, evaluation of serum inflammation markers level (CRP, IL-6, TNFa) were performed. Results. HRV time domain parameters adjusted by McanNN - SDNNn%, SDNNin%, rMSSDn%, pNN50% in women with SLE were lower than in healthy control. HRV parameters inversely correlated with inflammation markers in SLE (p<0,05). SLE pts were divided into 4 groups: 1 (n=12) - pts with low HRV parameters and high level of IL-6; 2 (n=13) - low HRV and normal IL-6; 3 (n=6) - normal HRV and high IL-6; 4 (n=44) - normal HRV and IL-6. SLEDA1 2K, left atrium size, levels of markers of inflammation in group 1 were higher, then in group 4 (p<0,05). Hypertension, dyslipidemia, smoking and subclinical atherosclerosis of carotid arteries were more frequent in group 2 compared to group 4 (p<0,05). Conclusion. These results suggest important role of autoimmune inflammation in pathogenesis of cardiac autonomic dysfunction in SLE pts with high disease activity and traditional cardiovascular risk factor, atherosclerotic changes - in low SLE activity. HRV, traditional cardiovascular risk factors and inflammatory markers combined measurement can help to identify subjects at risk of cardiovascular mortality among SLE pts.

References

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Novikova D.S., Popkova T.V., Panafidina T.A., Markelova E.L., Korsakova Y.O., Novikov A.A., Alexandrova E.N., Alekberova Z.S., Mach E.S., Nasonov E.L. Role of inflammation in the development of cardiac autonomic disfunction in patients with systemic lupus erythematosus. Rheumatology Science and Practice. 2008;46(6):4-10. (In Russ.) https://doi.org/10.14412/1995-4484-2008-484

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ISSN 1995-4484 (Print)
ISSN 1995-4492 (Online)