Neurological involvement is a well-documented issue in patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). However, little is known about the involvement of the autonomic nervous system. This study was conducted to investigate autonomic nervous system dysfunction in patients with RA and SLE. Twenty-six RA patients, 38 SLE patients and 40 healthy controls were recruited from our in- and out-patient departments. Heart rate variability (HRV) parameters (the power of the high- [HF] and low-frequency [LF] band of haemodynamic time series, the ratio between low- and high-frequency components [LF/HF ratio], the power spectral density), baroreflex sensitivity (BRS) and beat-to-beat blood pressures were assessed by a novel non-invasive haemodynamic monitoring tool (Task Force Monitor® [TFM], CNSystems Medizintechnik GmbH, Graz, Austria). Autonomic nervous system dysfunction was determined according to classical Ewing autonomic test battery. Furthermore, we implemented a secondary autonomic test score by modifying the Ewing test battery with additional criteria. Both the classical and modified Ewing test batteries have revealed that the frequencies of autonomic neuropathy were significantly higher in patient groups compared with controls (p < 0.001). Evaluation by TFM revealed that deterioration of sophisticated autonomic parameters (such as HRV and BRS) were more pronounced in the patient groups compared with controls. There was a significant association between BRS and Ewing test scores and abnormal BRS results were more frequent in patients with autonomic dysfunction according to Ewing test batteries. No relation was found between autonomic neuropathy and disease duration, disease activity and autoantibody positivity. Consequently, we believe that further large-scale studies investigating cardiovascular autonomic neuropathy in rheumatic diseases should be carried out to verify our findings and manifest clinical consequences beyond these results. Lupus (2010) 19, 255—261.

Cardiac autonomic dysfunction (CAD) is a common problem in patients with end‐stage renal disease (ESRD) and may contribute to the risk of cardiac mortality. Long‐term effects of dialysis modalities...

Objectives Cardiovascular diseases are the most common cause of death in the world. Oxidative stress has been proved to play a role in atherosclerotic diseases and 8-isoprostane is one of the most valid markers of in-vivo oxidative stress. We aimed to investigate the 8-isoprostane levels in relation to surrogate and direct angiographic indexes of atherosclerosis. Methods Urinary 8-isoprostane levels were measured and a B-mode carotid ultrasound examination was performed in 100 consecutive patients scheduled for coronary angiography. Results In patients with angiographic coronary artery disease (CAD) urinary 8-isoprostane levels were significantly (P<0.001) higher than in patients without CAD (68.75±5.5 vs. 38.27±3.7 pg/ml). Moreover, 8-isoprostane levels of patients with increased carotid intima media thickness (CIMT) were higher (P<0.001) than in patients with normal CIMT values (75.12±6.4 vs. 38.72±2.7 pg/ml). Moreover log(8-isoprostane) levels were significantly correlated with maximum and mean CIMT values (P<0.001) and across univessel and multivessel CAD groups levels of log(8-isoprostane) showed a significantly (P<0.001) increasing trend. Logistic regression analysis revealed that 8-isoprostane levels were an independent predictor for both intima-media thickening and angiographic CAD. Conclusion These findings indicate that elevated urinary levels of 8-isoprostane are associated with both subclinical atherosclerosis and manifest CAD. The results therefore support the hypothesis that isoprostanes-related oxidative stress is involved in the whole atherosclerotic process.

(2018). Evaluation of cardiac autonomic functions in myasthenia gravis. Neurological Research: Vol. 40, No. 5, pp. 405-412.