Autonomic nervous system functions in rheumatoid arthritis

Abstract EN

This present study was designed to assess the relationship between rheumatoid arthritis of varying severity and autonomic nervous system (ANS) using a number of non invasive well validated tests of cardiovascular autonomic functions, reflecting the overall state of autonomic function.

These tests included heart rate (HR) responses to deep breathing, valsalva ratio and HR variation with standing up (reflecting the parasympathetic function) and blood pressure responses to orthostasis and sustained hand grip tests (reflecting the sympathetic function).

The results were expressed , by giving the 5 tests an autonomic score for a normal, one for border line and 2 for an abnormal test giving a possible score from zero to 10 for all 5 tests.

Eleven patients with (MDAG) grade II, 10 patients with (MDAG) grade 111 and 15 healthy controls were included in the present study.

All patients had a normal blood sugar level.

They had no clinical evidence of cardiovascular or renal diseases.

The female patients were not pregnant.

The present study was also carried out to identify the degree of autonomic disturbance and whether it correlated to severity of the RA disease or not.

The results demonstrated clearly that autonomic dysfunction correlated with disease activity parameters.

One patient with MDAG grade U (9.09%) had a borderline autonomic neuropathy and also had clinical carpal tunnel syndrome.

While there were three patients with MDAG III; one with border line autonomic neuropathy (15.79%) and 2 with definite autonomic neuropathy.

All patients had clinical peripheral neuropathy.

Autonomic nerve dysfunction in all RA patients showed no correlation with the disease duration.