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Correlations between autonomic dysfunction and circadian changes and arrhythmia prevalence in women with fibromyalgia syndrome – Source: Anatolian Journal of Cardiology, Apr 2009

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Objective: It is known that increased sympathetic activity and decreased parasympathetic activity are present in patients with fibromyalgia syndrome (FMS). [Note: The autonomic nervous system directs “automatic” bodily functions. It has two parts: The sympathetic system is most active in times of stress; the parasympathetic system controls business as usual, helps conserve energy.]

This study aims to investigate the correlations of autonomic dysfunction and differences in autonomic circadian activity with arrhythmia prevalence in women with FMS.

Methods: Fifty female patients with FMS and 30 healthy female controls were included in this cross-sectional, case-controlled study.

• A 12-lead electrocardiogram and 24-hour Holter monitoring were performed in all patients to evaluate arrhythmias and autonomic function tests.

• Heart rate variability (HRV) parameters were utilized to detect autonomic dysfunction in patients with FMS.

• HRV measurements were performed in total 24-hour, day time (06:00-22:59), night time (23:00-05:59) periods and during autonomic tests (stand – supine, inspiration-expiration and Valsalva tests) using 24-hour Holter monitoring recordings.

• Student t-test, Mann-Whitney U and Pearson Chi-square tests were used for comparisons of the data between groups. The correlation of data was tested by using Spearman correlation analysis.

Results: The mean ages of the patient and control groups were 38+/- 7.4 and 36+/- 8.1 years, respectively.

In HRV measurements, high frequency (HF) power, was significantly decreased in the patient group as compared with control group (167.4 msec2 (107.0- 312.0) vs. 314.5 msec2 (124.0- 905.0), p=0.017).

The low frequency/HF ratio (LF/HF) values for total 24 hours (2.22+/- 0.18 vs. 1.22+/- 0.12, <0.001) and in the night time period (2.78+/- 1.97 vs.1.15+/- 0.77, <0.001) were found to be significantly higher in the patient group than in control one.

The ratio of LF/HFDay / LF/HFNight was markedly higher in the control group (2.67 (1.22- 5.65) vs. 1.45 (0.83- 2.05), p=0.004).

The prevalence (p=0.028) and total number (127.1+/- 21.4 vs. 187.3+/- 62.3, p=0.019) of supraventricular extrasystoles in 24-hour period was higher in the patient group.

Conclusion:

• The sympathetic activity was significantly increased and parasympathetic activity significantly decreased in FMS patients.

• Additionally, significant autonomic circadian activity changes were also detected in these patients.

• These autonomic changes might be linked to increased arrhythmia prevalence.

Source: Anatolian Journal of Cardiology, Apr 2009;9(2):110-117. PMID: 19357052 , by Dogru MT, Aydin G, Tosun A, Keles I, Guneri M, Arslan A, Ebinc H, Orkun S. PMID: 19357052 , by Department of Cardiology, Faculty of Medicine, University of Kirikkale, Kirikkale, Turkey. [E-mail: mtolgadogru@gmail.com]

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