The ClinicianThe ClinicianКлиницист1818-83382412-8775Publishing House ABV Press12210.17650/1818-8338-2011-2-57-61ORIGINAL INVESTIGATIONSОРИГИНАЛЬНОЕ ИССЛЕДОВАНИЕAUTONOMIC CARDIOVASCULAR REGULATION DISORDERS IN PATIENTS WITH PSORIATIC ARTHRITISНАРУШЕНИЯ АВТОНОМНОЙ РЕГУЛЯЦИИ СЕРДЕЧНОЙ ДЕЯТЕЛЬНОСТИ У БОЛЬНЫХ ПСОРИАТИЧЕСКИМ АРТРИТОМRebrovA. P.РебровА. П.
Russian Federation
andreyrebrov@yandex.ruPoddubnyyD. A.ПоддубныйД. А.
Russian Federation
GaydukovaI. Z.ГайдуковаИ. З.
Russian Federation
Razumovsky Saratov State Medical University, Ministry of Health and Social Development of RussiaГОУ ВПО Саратовский ГМУ им. В.И. Разумовского Минздравсоцразвития РоссииRegional HospitalГУЗ Областная клиническая больница150420115257611707201417072014Copyright ©; 2011, Rebrov A.P., Poddubnyy D.A., Gaydukova I.Z.Copyright ©; 2011, Ребров А.П., Поддубный Д.А., Гайдукова И.З.2011Rebrov A.P., Poddubnyy D.A., Gaydukova I.Z.Ребров А.П., Поддубный Д.А., Гайдукова И.З.https://creativecommons.org/licenses/by/4.0https://klinitsist.abvpress.ru/Klin/article/view/122

Aim – to identify disorders of autonomic regulation of cardiac activity in patients with psoriatic arthritis (PsA) by determining the heart rate variability (HRV), and also establish the relationship of HRV with systemic inflammation and traditional cardiovascular risk factors.

Materials and methods. The study included 53 patients with PsA (mean age 43.64 ± 12.1 years), including 48.2 % men, mean disease durationwas 10.32 ± 10.2 years. The control group included 25 healthy volunteers (average age 46.7 ± 12.45 years, 49.1 % – men). Time andfrequency measures of HRV were analyzed. Active PsA was determined by an index DAS4, rate erythrocyte sedimentation rate (ESR), levels of C-reactive protein (CRP) and fibrinogen. Patients with clinical manifestations of cardiovascular disease, and patients with symptomsof carotid atherosclerosis, detected by duplex study were excluded.

Results. Deterioration of HRV in patients with PsA compared with those in patients of the control group, the availability of statistically significant reverse relationship of temporal and spectral parameters of HRV with PsA activity (ESR, CRP, entezit score, DAS4), duration of arthritis, the classical factors of cardiovascular risk were established.

Conclusion. Patients with PsA had noted a violation of autonomic regulation of cardiac activity in the form of reduced HRV and activation of the sympathetic part of it. Identified changes were associated with activity of systemic inflammation and classical factors of cardiovascular risk.

heart rate variabilitypsoriatic arthritisвариабельность сердечного ритмапсориатический артрит1. Ревматология: национальное руководство. Под ред. Е.Л. Насонова, В.А. Насоновой. М.: ГЭОТАР-Медиа, 2005.Ревматология: национальное руководство. Под ред. Е.Л. Насонова, В.А. Насоновой. М.: ГЭОТАР-Медиа, 2005.2. Gladman D.D., Farewell V.T., Wong K., Husted J. Mortality studies in psoriatic arthritis: results from a single outpatient center. II. Prognostic indicators for death. Arthritis Rheum 1998;41:1103–10.Gladman D.D., Farewell V.T., Wong K., Husted J. Mortality studies in psoriatic arthritis: results from a single outpatient center. II. Prognostic indicators for death. Arthritis Rheum 1998;41:1103–10.3. Antivalle M., Mutti A., Randisi G., et al. Prevalence of metabolic syndrome, risk factor clustering, inflammatory markers, and cardiovascular morbidity in rheumatoid arthritis and spondyloarthritis. Ann Rheum Dis 2006;65(Suppl II):160.Antivalle M., Mutti A., Randisi G., et al. Prevalence of metabolic syndrome, risk factor clustering, inflammatory markers, and cardiovascular morbidity in rheumatoid arthritis and spondyloarthritis. Ann Rheum Dis 2006;65(Suppl II):160.4. Бадокин В.В., Янышева А.В., Александрова Е.Н. и др. Риск развития сердечно- сосудистых заболеваний при псориатическом артрите. Терапевтический архив 2009;(6):41–7.Бадокин В.В., Янышева А.В., Александрова Е.Н. и др. Риск развития сердечно- сосудистых заболеваний при псориатическом артрите. Терапевтический архив 2009;(6):41–7.5. Han C., Robinson D.W., Hackett M.V., et al. Cardiovascular disease and risk factors in patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. J Rheumatol 2006;33:2167–72.Han C., Robinson D.W., Hackett M.V., et al. Cardiovascular disease and risk factors in patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. J Rheumatol 2006;33:2167–72.6. Neiman A.L., Shin D.B., Wang X., et al. Prevalence of cardiovascular risk factors in patients with psoriasis. J Am Acad Dermatol 2006;55:829–35.Neiman A.L., Shin D.B., Wang X., et al. Prevalence of cardiovascular risk factors in patients with psoriasis. J Am Acad Dermatol 2006;55:829–35.7. Sajadieh A., Nielsen O.W., Rasmussen V., et al. Increased heart rate and reduced heartrate variability are associated with subclinical inflammation in middle-aged and elderly subjects with no apparent heart disease. Eur Heart J 2004;25:363–70.Sajadieh A., Nielsen O.W., Rasmussen V., et al. Increased heart rate and reduced heartrate variability are associated with subclinical inflammation in middle-aged and elderly subjects with no apparent heart disease. Eur Heart J 2004;25:363–70.8. Sloan R.P., McCreath H., Tracey K.J., et al. RR interval variability is inversely related to inflammatory markers: the CARDIA study. Mol Med 2007;13:178–84.Sloan R.P., McCreath H., Tracey K.J., et al. RR interval variability is inversely related to inflammatory markers: the CARDIA study. Mol Med 2007;13:178–84.9. Lampert R., Bremner J.D., Su S., et al. Decreased heart rate variability is associated with higher levels of inflammation in middleaged men. Am Heart J 2008;156:751–7.Lampert R., Bremner J.D., Su S., et al. Decreased heart rate variability is associated with higher levels of inflammation in middleaged men. Am Heart J 2008;156:751–7.10. Новикова Д.С., Коротаева Е.Ю., Логинова Е.Ю. и др. Клиническое значение оценки вариабельности ритма сердца у больных псориатическим артритом. Терапевтический архив 2009;(6):47–52.Новикова Д.С., Коротаева Е.Ю., Логинова Е.Ю. и др. Клиническое значение оценки вариабельности ритма сердца у больных псориатическим артритом. Терапевтический архив 2009;(6):47–52.11. Поддубный Д.А., Гайдукова И.З., Ребров А.П. Вариабельность ритма сердца у больных анкилозирующим спондилитом (болезнь Бехтерева). Терапевтический архив 2009;(6):56–62.Поддубный Д.А., Гайдукова И.З., Ребров А.П. Вариабельность ритма сердца у больных анкилозирующим спондилитом (болезнь Бехтерева). Терапевтический архив 2009;(6):56–62.12. Tsuji H., Larson M.G., Venditti F.J. Jr., et al. Impact of reduced heart rate variability on risk for cardiac events. The Framingham Heart Study. Circulation 1996;94:2850–5.Tsuji H., Larson M.G., Venditti F.J. Jr., et al. Impact of reduced heart rate variability on risk for cardiac events. The Framingham Heart Study. Circulation 1996;94:2850–5.13. de Bruyne M.C., Kors J.A., Hoes A.W., et al. Both decreased and increased heart rate variability on the standard 10-second electrocardiogram predict cardiac mortality in the elderly: the Rotterdam Study. Am J Epidemiol 1999;150:1282–8.de Bruyne M.C., Kors J.A., Hoes A.W., et al. Both decreased and increased heart rate variability on the standard 10-second electrocardiogram predict cardiac mortality in the elderly: the Rotterdam Study. Am J Epidemiol 1999;150:1282–8.14. Dekker J.M., Crow R.S., Folsom A.R., et al. Low heart rate variability in a 2-minute rhythm strip predicts risk of coronary heart disease and mortality from several causes: the ARIC Study. Atherosclerosis Risk In Communities. Circulation 2000;102:1239–44.Dekker J.M., Crow R.S., Folsom A.R., et al. Low heart rate variability in a 2-minute rhythm strip predicts risk of coronary heart disease and mortality from several causes: the ARIC Study. Atherosclerosis Risk In Communities. Circulation 2000;102:1239–44.15. Mease P., Goffe B. Diagnosis and treatment of psoriatic arthritis. J Am Acad Dermatol 2005;52:1–19.Mease P., Goffe B. Diagnosis and treatment of psoriatic arthritis. J Am Acad Dermatol 2005;52:1–19.16. Kavanaugh A., Ritchlin C.; GRAPPA Treatment Guideline Committee. Systematic review of treatments for psoriatic arthritis: an evidence based approach and basis for treatment guidelines. J Rheumatol 2006;33(7):1417–21.Kavanaugh A., Ritchlin C.; GRAPPA Treatment Guideline Committee. Systematic review of treatments for psoriatic arthritis: an evidence based approach and basis for treatment guidelines. J Rheumatol 2006;33(7):1417–21.17. Sajadieh A., Nielsen O.W., Rasmussen V., et al. C-reactive protein, heart rate variability and prognosis in community subjects with no apparent heart disease. J Intern Med 2006;260:377–87.Sajadieh A., Nielsen O.W., Rasmussen V., et al. C-reactive protein, heart rate variability and prognosis in community subjects with no apparent heart disease. J Intern Med 2006;260:377–87.18. Madsen T., Christensen J.H., Toft E., Schmidt E.B. C-reactive protein is associated with heart rate variability. Ann Noninvasive Electrocardiol 2007;12:216–22.Madsen T., Christensen J.H., Toft E., Schmidt E.B. C-reactive protein is associated with heart rate variability. Ann Noninvasive Electrocardiol 2007;12:216–22.