Cardiovascular autonomic regulation, inflammation and pain in rheumatoid arthritis.
Cardiovascular autonomic regulation, inflammation and pain in rheumatoid arthritis.
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DOI：
10.1016/j.autneu.2017.09.003
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发表时间：
2017-12
期刊：
影响因子：
--
通讯作者：
Fisher JP
中科院分区：
文献类型：
--
作者：
Adlan AM;Veldhuijzen van Zanten JJCS;Lip GYH;Paton JFR;Kitas GD;Fisher JP
类风湿性关节炎（RA）是一种慢性炎症性疾病，其特征是不明原因的心率变异性（HRV）降低。我们验证了低HRV（表明心脏自主心血管功能障碍）与全身炎症和疼痛相关的假设。考虑到RA中高血压（HTN）的高患病率，高血压本身与低HRV相关，我们还评估了高血压的存在是否会进一步降低RA中的HRV。在ra -正常血压组（n = 13）、RA-HTN组（n = 17）、正常血压组（NC; n = 17）和HTN组（n = 16）中记录血压和心率。测定HRV的时域和频域以及炎症的血清学标志物（高敏c反应蛋白[hs-CRP]、肿瘤坏死因子-α [TNF-α]和白细胞介素[IL]）。报告的疼痛用视觉模拟量表评估。与NC相比，RA、RA-HTN和HTN组HRV的时间（rMSSD, pNN50%）和频率（高频功率，低频功率，总功率）域测量值较低（p = 0.001）。然而，RA、RA-HTN和HTN组之间HRV无显著差异。HRV测量的时间和频率与炎症细胞因子（IL-6和IL-10）呈负相关，但在多变量分析后不是独立的。hs-CRP、疼痛与HRV时域参数（rMMSD、pNN50%）呈独立负相关。这些发现表明，较低的HRV与炎症增加有关，并与报告的疼痛增加独立相关，但与RA患者HTN的存在无关。类风湿性关节炎（RA）是一种慢性炎症性疾病，伴有低心率变异性（HRV）。重要的自主免疫相互作用被认为是RA，但尚未彻底检查。我们发现，RA的低HRV与血清炎症细胞因子水平升高和患者报告的疼痛有关。在我们的类风湿性关节炎患者中，HRV的降低并没有伴随着高血压的出现。
Rheumatoid arthritis (RA) is a chronic inflammatory condition characterised by reduced heart rate variability (HRV) of unknown cause. We tested the hypothesis that low HRV, indicative of cardiac autonomic cardiovascular dysfunction, was associated with systemic inflammation and pain. Given the high prevalence of hypertension (HTN) in RA, a condition itself associated with low HRV, we also assessed whether the presence of hypertension further reduced HRV in RA. In RA-normotensive (n = 13), RA-HTN (n = 17), normotensive controls (NC; n = 17) and HTN (n = 16) controls, blood pressure and heart rate were recorded. Time and frequency domain measures of HRV along with serological markers of inflammation (high sensitivity C-reactive protein [hs-CRP], tumour necrosis factor-α [TNF-α] and interleukins [IL]) were determined. Reported pain was assessed using a visual analogue scale. Time (rMSSD, pNN50%) and frequency (high frequency power, low frequency power, total power) domain measures of HRV were lower in the RA, RA-HTN and HTN groups, compared to NC (p = 0.001). However, no significant differences in HRV were noted between the RA, RA-HTN and HTN groups. Inverse associations were found between time and frequency measures of HRV and inflammatory cytokines (IL-6 and IL-10), but were not independent after multivariable analysis. hs-CRP and pain were independently and inversely associated with time domain (rMMSD, pNN50%) parameters of HRV. These findings suggest that lower HRV is associated with increased inflammation and independently associated with increased reported pain, but not compounded by the presence of HTN in patients with RA. Rheumatoid arthritis (RA) is a chronic inflammatory condition accompanied by low heart rate variability (HRV). Important autonomic-immune interactions are suggested, but have not been thoroughly examined in RA. We show that low HRV in RA is associated with increased serum inflammatory cytokine levels and patient-reported pain. In our patients with RA, reductions in HRV were not compounded by the presence of hypertension.
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