Characteristics of cardiovascular autonomic dysfunction and association with quality of life in patients with systemic lupus erythematosus

ObjectivesCardiovascular autonomic neuropathy (CAN) may affect the clinical course of SLE leading to reduced quality of life. CAN is assessed by heart rate variability (HRV) measures and cardiovascular autonomic reflex tests (CARTs). In patients with SLE, we aimed to determine the characteristics of...

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Bibliographic Details
Published in:Lupus science & medicine 2021-07, Vol.8 (1), p.e000507
Main Authors: Zinglersen, Amanda Hempel, Iversen, Katrine Kjær, Leffers, Henrik Christian Bidstrup, Laugesen, Esben, Fleischer, Jesper, Jacobsen, Søren
Format: Article
Language:English
Subjects:
Autonomic Nervous System
cardiovascular diseases
Cardiovascular System
Co-Morbidities
Diabetes
Disease
Electrocardiography
Heart rate
Humans
Lupus
lupus erythematosus, systemic
Lupus Erythematosus, Systemic - complications
Nervous system
Patients
Primary Dysautonomias
Quality of Life
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Summary:ObjectivesCardiovascular autonomic neuropathy (CAN) may affect the clinical course of SLE leading to reduced quality of life. CAN is assessed by heart rate variability (HRV) measures and cardiovascular autonomic reflex tests (CARTs). In patients with SLE, we aimed to determine the characteristics of CAN and if CAN associates with health-related quality of life (HRQoL).MethodsPatients with SLE and healthy controls (HCs) were CAN tested with 5 min HRV and three CARTs to determine parameters reflecting parasympathetic and mixed sympathetic–parasympathetic function. Subjects were classified as having no, early or definitive CAN by having none, one or more than one abnormal CART, respectively. HRQoL as determined by the Short Form 12 (SF-12) was assessed in SLE.ResultsOf 111 patients with SLE, 92 answered the SF-12 and 54 were matched with 54 HCs for characterisation of CAN. Definitive CAN was present in 24.1% (95% CI 15% to 37%) patients with SLE and 1.9% (95% CI 0.3% to 9.8%) HCs (OR 16.8, 95% CI 2.1 to 133.8, p=0.008). The corresponding prevalences of any CAN were 53.7% (95% CI 41% to 66%) and 22.6% (95% CI 13% to 35%). SLE patients with definitive CAN showed signs of mixed sympathetic–parasympathetic dysfunction, whereas patients without CAN primarily presented with impaired parasympathetic activity. Signs of parasympathetic as well as sympathetic–parasympathetic dysfunction were associated with low physical SF-12 component score (all: β>0.211, p
ISSN:2053-8790
2053-8790
DOI:10.1136/lupus-2021-000507