Cardiovascular autonomic nervous system dysfunction in patients with rheumatoid arthritis and systemic lupus erythematosus

Although peripheral and central nervous system involvement havebeen well recognized in patients with rheumatoid arthritis (RA)and systemic lupus erythematosus (SLE), autonomic nervous system(ANS) involvement has rarely been studied, and has shown conflictingresults. We performed cardiovascular ANS assessment in 34 RAand 37 SLE patients, using standard cardiovascular reflex tests.The results in each patient were compared with age- and sex-matchedhealthy controls. Forty-seven percent of the RA patients and19% of the SLE patients had symptoms suggesting ANS dysfunction.The heart rate variation in response to deep breathing was significantlydecreased in both the RA and SLE patients (p=0.001). This diminishedheart rate response showed no correlation with the disease duration,the number of swollen joints, the Ritchie articular index, ESR,or rheumatoid factor in the RA group, or the disease duration,the SLEDAI score or ESR in the SLE group. The clinical significanceof the diminished cardiovascular ANS response needs to be investigated.