Cardiac autonomic function in patients with rheumatoid arthritis: heart rate turbulence analysis

Objective: Rheumatoid arthritis (RA) is a chronic systemic disease. The risk of cardiovascular morbidity and mortality is high in patients with RA. Heart rate turbulence (HRT) expresses ventriculophasic sinus arrhythmia and has been considered to reflect cardiac autonomic activity. It has been shown that HRT is an independent and powerful predictor of mortality. The aim of this study is to determine if HRT changes in patients with RA in comparison with the healthy controls. Methods: The study was performed as a cross-sectional study. Twenty-six patients with RA (mean age 56±10 years, 18 women) and 26 healthy controls (mean age 55±9 years, 18 women) were enrolled in this study. All participants underwent 24 hours Holter electrocardiogram monitoring. HRT measurements, turbulence onset (TO) and turbulence slope (TS), were calculated in patients and healthy controls that have at least one ventricular premature complex (VPC) in their Holter recordings. TO is a measure of the early sinus acceleration and TS is the measure of the rate of sinus deceleration that follows the sinus acceleration after a VPC. Mann-Whitney U test was used for comparison of continuous variables and the Chi-square test for comparison of categorical variables. Results: There were no statistically significant differences in TO and TS between the RA and control groups (TO: -2.2±3.1% vs -2.8±2.5%, p=0.25; TS: 11.5±9.7 ms/RR vs 15.5±10.9 ms/RR, p=0.10). Conclusion: HRT parameters, which determine the autonomic dysfunction, did not seem to be altered in patients with RA.