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ASSOCIATION BETWEEN HEART RATE VARIABILITY AND COMPONENTS OF THE METABOLIC SYNDROME IN WOMEN WITH RHEUMATOID ARTHRITIS

https://doi.org/10.20996/1819-6446-2014-10-1-18-24

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Abstract

Aim. To study the relationship between heart rate variability (HRV) and components of the metabolic syndrome (MS) in women with rheumatoid arthritis (RA).

Material and methods. Female patients (n=291) with a firm RA diagnosis under 60 years of age were examined. Evaluation of traditional cardiovascular risk factors, MS components (International Diabetes Federation criteria), 24-hour ECG monitoring were performed along with the assessment of clinical symptoms, the degree of activity and severity of RA.

Results. Weak associations of HRV with waist circumference, blood pressure level, hypertriglyceridemia, hypoalphalipoproteinemia and smoking were found in the correlation analysis. Patients with RA were divided into three groups depending on the number of existing MS components. Group 1 (0-1 component) included 113 women (39%), group 2 (2-3 components) – 109 women (37%) and group 3 (4-5 components) – included 69 women with RA (24%). Progressive decrease in the absolute values and the increase in the percentage of the low values of all the studied time and frequency HRV indices, adjusted by age and heart rate, from the 1st to the 3rd group of women with RA were determined. Significant increase in sympathovagal index from the 1st to the 3rd group was also shown.

Conclusion. A combination of several components of the MS in RA plays a greater role in the development of disorders of neurovegetative autonomic control of heart activity (increased influence of the sympathetic and/or reduced influence of the parasympathetic nervous system on cardiac function) than each traditional cardiovascular risk factor taken separately. Abnormality in autonomic regulation of cardiac activity may be an important link in the pathogenesis of cardiac arrhythmias, sudden cardiac death and overall cardiovascular mortality in women with RA.

About the Authors

D. S. Novikova
V.A. Nasonova Research Institute of Rheumatology, Moscow
Russian Federation


T. V. Popkova
V.A. Nasonova Research Institute of Rheumatology, Moscow
Russian Federation


A. N. Gerasimov
I.M. Sechenov First Moscow State Medical University
Russian Federation


A. V. Volkov
V.A. Nasonova Research Institute of Rheumatology, Moscow
Russian Federation


E. L. Nasonov
V.A. Nasonova Research Institute of Rheumatology, Moscow
Russian Federation


References

1. Литература

2. Popkova TV, Novikova DS, Nasonov EL. Atherosclerosis in rheumatic diseases. In: Nasonov EL, editor. Rheumatology: clinical guidelines. Moscow: Geotar Media; 2010: 678-702. Russian (Попкова Т.В., Новикова Д.С., Насонов Е.Л. Атеросклероз при ревматических заболеваниях. В: Насонов Е.Л., редактор. Ревматология: клинические рекомендации. M.: Геотар-Медиа; 2010: 678-702).

3. Peters M.J., Symmons D.P., McCarey D.W. et al. EULAR evidence-based recommendations for cardiovascular risk management in patients with rheumatoid arthritis and other types of inflammatory arthritis — TASK FORCE «Cardiovascular risk management in RA». Ann Rheum Dis 2010; 69:325-31.

4. Meune C., Touzé E., Trinquart L., Allanore Y. High risk of clinical cardiovascular events in RA: levels of associations of myocardial infarction and stroke through a systematic review and meta-analysis. Arch Cardiovasc Dis 2010;103:253-61.

5. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart rate variability: standards of measurement, physiological interpretation and clinical use. Circulation 1996; 93:1043-65.

6. Crawford M.H., Bernstein S.J., Deedwania P.C. et al. ACC/AHA Guidelines for Ambulatory Electrocardiography. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the Guidelines for Ambulatory Electrocardiography). Developed in collaboration with the North American Society for Pacing and Electrophysiology. JACC 1999; 34(3):912-48.

7. Wolf M.M., Varigos G.A., Hunt D., Sloman J.G. Sinus arrhythmia in acute myocardial infarction. Med J Aust 1978; 15(2):52-3.

8. Kleiger R.E. Decreased heart rate variability and its association with increased mortality after acute myocardial infarction. Am J Cardiol 1987; 59:256-62.

9. Bigger J.T. Frequency domain measures of heart period variability and mortality rate after myocardial infarction. Circulation 1992; 85:164-71.

10. Tapanainen J.M., Thomsen P.E., Kober L. et al. Fractal analysis of heart rate variability and mortality after an acute myocardial infarction. Am J Cardiol 2002: 90:347-52.

11. Yi G., Goldman J.H., Keeling P.J. et al. Heart rate variability in idiopathic dilated cardiomyopathy: relation to disease severity and prognosis. Heart 1997: 77(2):108-14.

12. Nolan J., Batin P.D., Andrews N. et al. Prospective study of heart rate variability and mortality in chronic heart failure: results of the United Kingdom heart failure evaluation and assessment of risk trial (UKHeart). Circulation 1998; 98:1510-6.

13. Schroeder E.B., Chambless L.E., Liao D. et al. Diabetes, glucose, insulin and heart rate variability: the Atherosclerosis Risk in Communities (ARIC) study. Diabetes care 2005; 28(3):668-74.

14. Ko S.H., Song K.H., Park S.A. et al. Cardiovascular autonomic dysfunction predicts acute ischaemic stroke in patients with Type 2 diabetes mellitus: a 7-year follow-up study. Diabet Med 2008; 25(10):1171-7.

15. Huikuri H., Ylitalo A., Pikkujamsa S.M. et al. HR variability in systemic hypertension. Am J Cardiol 1996; 77(12):1073-7.

16. Park S.K., Schwartz J., Weisskopf M. et al. Low-level lead exposure, metabolic syndrome, and heart rate variability: The VA normative aging study. Environ Health Perspect 2006; 114(11):1718-24.

17. Evrengül H., Dursunoglu D., Cobankara V. et al. Heart rate variability in patients with rheumatoid arthritis. RheumatolInt 2004; 24(4):198-202.

18. Parnes EY, Krasnosel'skii MJ, Tsurko VV, et al. Long-term prognosis in patients with rheumatoid arthritis, according to baseline heart rate variability. Therapeutic Archive 2005; (9):77-80. Russian (Парнес Е.Я., Красносельский М.Я., Цурко В.В. и др. Долгосрочный прогноз у больных ревматоидным артритом в зависимости от исходной вариабельности сердечного ритма. Тер Aрхив 2005; (9):77-80).

19. Stojanovich L., Milovanovich B., de Luka S.R. Cardiovascular autonomic dysfunction in systemic lupus, rheumatoid arthritis, primary Sjogren syndrome and other autoimmune diseases. Lupus 2007; 16(3):181-5.

20. Anichkov D.A., Shostak N.A., Ivanov D.S. Heart rate variability is related to disease activity and smoking in rheumatoid arthritis patients. Int J ClinPract 2007; 61:777-83.

21. Novikova D.S., Popkova T.V., Gavva T.N. et al. Comparative evaluations of heart rate variability parameters, disease activity and markers of inflammation in patients with rheumatoid arthritis. Ann rheum diseases 2008; 67(suppl II):308.

22. Novikova DS, Popkova TV, Markelova EI et al. The clinical significance of heart rate variability in patients with rheumatoid arthritis. Clinical Medicine 2009; (1) :27-32. Russian (Новикова Д.С., Попкова Т.В., Маркелова Е.И. и соавт. Клиническое значение оценки вариабельности ритма сердца у больных ревматоидным артритом. Клиническая Медицина 2009;(1):27-32).

23. Anichkov DA, Platonova AA. The clinical significance of heart rate variability (according to 5-minute and 24-hour ECG recordings) in patients with rheumatoid arthritis. Rational Pharmacother Card 2009; (1):77-82. Russian (Аничков Д.А., Платонова А.А.. Клиническое значение показателей вариабельности сердечного ритма (по данным 5-минутных и 24-часовых записей ЭКГ) у больных ревматоидным артритом. Рациональная Фармакотерапия в Кардиологии 2009; (1):77-82).

24. Arnett F.C., Edworthy S.M., Bloch D.A. The ARA 1987 revised criteria for classification of rheumatoid arthritis. Arthritis Rheum 1988; 31:315-24.

25. Nasonov EL, editor. Rheumatology. Clinical recommendations. Moscow: Geotar Media; 2010. Russian (Насонов Е.Л., редактор. Ревматология. Клинические рекомендации. М.: ГЭОТАР-Медиа; 2010).

26. De Backer G., Ambrosioni E., Borch-Johnsen K. et al. Third Joint Force of European and other Societies on Cardiovascular Disease and Prevention in Clinical Practice. European guidelines on cardiovascular disease and prevention in clinical practice. Atherosclerosis 2003;171:145-55.

27. Alberti K.G., Zimmet P., Shaw J. et al. IDF Epidemiology Task Force Consensus Group. The metabolic syndrome: a new worldwide definition. Lancet 2005; 366: 1059-1062.

28. Novikova DS, Gerasimov AN, Popkova TV et al. Comparison of heart rate variability normalized by age and heart rate in women with rheumatoid arthritis and rheumatic diseases zhenschinbez. Rational Pharmacother Card 2013; 9 (2):127-32. Russian (Новикова Д.С., Герасимов А.Н., Попкова Т.В. и др. Сравнение показателей вариабельности ритма сердца, нормированных по возрасту и частоте сердечных сокращений, у женщин с ревматоидным артритом и женщинбез ревматических заболеваний. Рациональная Фармакотерапия в Кардиологии 2013;9(2):127-32).

29. Gerasimov A.N. Medical statistics. Moscow: MIA; 2007. Russian (Герасимов А.Н. Медицинская статистика. М.: МИА; 2007).

30. Popkova TV, Helkovskaya AN, Mach ES, et al. Cardiovascular disease in rheumatoid arthritis. Therapeutic Archive 2007; (5): 9-14. Russian (Попкова Т.В., Хелковская А.Н., Мач Э.С. и др. Сердечно-сосудистые заболевания при ревматоидном артрите. Тер Aрхив; 2007; (5):9-14.

31. Popkova TV, Novikova DS, Nasonov EL. Cardiovascular risk factors in rheumatic diseases: relationship with inflammation. Consilium Medicum 2010 (2):112-8. Russian (Попкова Т.В., Новикова Д.С., Насонов Е.Л. Кардиоваскулярные факторы риска при ревматических заболеваниях: связь с воспалением. Consilium Medicum 2010; (2):112-8).

32. Sidiropoulos P. I., Karvounaris S. A., Boumpas D. T. Metabolic syndrome in rheumatic disease: epidemiology, pathophysiology, and clinical implications. Arthr Research Therapy 2008;10:207.

33. Mancia G, Bousquet P, Elghozi J et al. The sympathetic nervous system and the metabolic syndrome. J Hypertens 2007; 25:909-20.

34. Tentolouris N, Liatis S, Katsilambros N. Syspathehic system activity in obesity and metabolic syndrome. Ann N Y Acad Sci 2006; 1083:129-52.

35. Carr MC. The emergence of the metabolic syndrome with menopause. J Clin Endocrinol Metab 2003; 88(6):2404-11.

36. Bragina AE, Salimzhanova YN, Panfilova EJ, Fomina IG. State of the renin-angiotensin-aldosterone system in women with hypertension in menopause. Cardiovascular Therapy and Prevention 2005; 4 (6) :92-7. Russian (Брагина А.Е., Салимжанова Ю.Н., Панфилова Е.Ю., Фомина И.Г. Состояние ренин-ангиотензин-альдостероновой системы у женщин с артериальной гипертензией в климактерическом периоде. Кардиоваскулярная Терапия и Профилактика 2005;4(6):92-7).

37. Podzolkov VI, Bragina AE, Panferova EK. Vegetative status and its relationship to humoral factors in perimenopausal women. Systemic Hypertension 2010; (4):62-7. Russian (Подзолков В.И., Брагина А.Е., Панферова Е.К. Состояние вегетативного статуса и его взаимосвязь с гуморальными факторами у женщин в перименопаузе. Системные Гипертензии 2010; (4):62-7).

38. Alpert MA. Obesity cardiomyopathy: patophysiology and evolution of clinical syndrome. Am J MedSci 2001; 321(4):1213-9.

39. Ash-Bernal R, Peterson LR. The cardiometabolic syndrome and cardiovascular disease. J CardiometabSyndr 2006;1:25-8.

40. Dessein P.H., Tobias M., Veller M.G. Metabolic syndrome and subclinical atherosclerosis in rheumatoid arthritis. J Rheumatol 2006; 33:2425-32.

41. Chung C. P., Oeser A., Joseph F. Prevalence of the metabolic syndrome is increased in rheumatoid arthritis and is associated with coronary atherosclerosis. Atherosclerosis 2008; 196(2):756-63.

42. Myasoedova E., Crowson C.S., Kremers H.M.et al. Lipid paradox in rheumatoid arthritis: the impact of serum lipid measures and systemic inflammation on the risk of cardiovascular disease. AnnRheumDis 2011;70(3):482-7.

43. Choi E., Sattar N. Interpreting lipid levels in the context of high-grade inflammatory states with a focus on rheumatoid arthritis: a challenge to conventional cardiovascular risk actions. AnnRheumDis 2009; 68:460-9.

44. Manolio T.A., Pearson T.A., Wenger N.K., et al. Cholesterol and heart disease in older persons and women. Rewiew of an NHLBI workshop. Ann Epidemiol 1992; 2:161-76.

45. Bass K.M., Newschaffer C.J., Klag M.J., Bush T. L. Plasma lipopritein levels as predictors of cardiovascular death in women. Arch Intern Med 1993; 153:2209-16.

46. Liao D., Sloan R.P., Cascio W.E. et al. Multiple metabolic syndrome is associated with lower heart rate variability. The Atherosclerosis Risk in Communities Study. Diabetes Care 1998; 21:2116-22.

47. Hemingway H., Shipley M., Brunner E. et al. Does autonomic function link social position to coronary risk? The Whitehall II study. Circulation 2005; 111:3071-7.

48. Stein P.K., Barzilay J.I., Domitrovich P.P. et al. The relationship of heart rate and heart rate variability to non-diabetic fasting glucose levels the metabolic syndrome: the Cardiovascular Health Study. Diabet Med 2007; 24:855-63.

49. Khurs EM, Andreev PV, Poddubnaya AV, et al. Autonomic imbalance in the pathogenesis of the metabolic syndrome. Clinical Medicine 2010; (6): 39-43. Russian (Хурс Е.М., Андреев П.В., Поддубная А.В. и соавт. Вегетативный дисбаланс в патогенезе метаболического синдрома. Клиническая Медицина 2010; (6): 39-43).

50. Min K.B., Min J.Y., Paek D., Cho S.I. The impact of the components of metabolic syndrome on heart rate variability: using the NCEP-ATP III and IDF definitions. Pacing Clin Electrophysiol 2008; 31(5):584-91.

51. Assoumou H.G., Pichot V., Barthelemy J.C. et al. Metabolic syndrome and short-term and long-term heart rate variability in elderly free of clinical cardiovascular disease: the PROOF study. Rejuvenation Res 2010; 13(6):653-63.

52. Nevzorova VA, Abramov EA, Vlasenko A. Features of lipid profile, blood pressure variability and heart rate in patients with clinical manifestations of the metabolic syndrome. Herald Arrhythmologists 2004; 36:27-30. Невзорова, В. А., Абрамов, Е. А., Власенко, А. Н. Особенности липидного спектра, вариабельности артериального давления и сердечного ритма у больных с клиническими проявлениями метаболического синдрома. Вестник Аритмологии 2004; 36:27-30.

53. Kratnov AE, Klimachova OB, Tretyakov CB Influence factors of the metabolic syndrome change of heart rate variability. Modern Technologies in Medicine 2011; (3):102-5. Russian (Кратнов A.E., Климачева O.B., Tретьяков C.B. Влияние факторов метаболического синдрома на изменение вариабельности ритма сердца. Современные Технологии в Медицине 2011; (3):102-5).

54. Gehi A., Lampert R., Veledar E. et al. A twin study of metabolic syndrome and autonomic tone. J Cardiovasc Electrophysiol 2009; 20(4):422-8.

55. Gonzalez-Gay M.A, De Matias J.M, Gonzalez-Juanatey C. et al. Anti-tumor necrosis factor-alpha blockade improves insulin resistance in patients with rheumatoid arthritis. Clin Exp Rheumatol 2006; 24:83-6.


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For citations:


Novikova D.S., Popkova T.V., Gerasimov A.N., Volkov A.V., Nasonov E.L. ASSOCIATION BETWEEN HEART RATE VARIABILITY AND COMPONENTS OF THE METABOLIC SYNDROME IN WOMEN WITH RHEUMATOID ARTHRITIS. Rational Pharmacotherapy in Cardiology. 2014;10(1):18-24. (In Russ.) https://doi.org/10.20996/1819-6446-2014-10-1-18-24

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