ASSESSMENT OF AUTONOMIC FUNCTION IN RHEUMATOID ARTHRITIS PATIENTS USING TILT-TABLE TEST IN A TERTIARY CARE TEACHING HOSPITAL
Dr. P. V. Saraswathi* and Dr. Amudhan Arvind
Introduction: Rheumatoid Arthritis (RA) is a chronic inflammatory disorder affecting primarily the peripheral joints. This disorder not only affects the joints but also many systems like the Respiratory, Cardiovascular and the Nervous system particularly autonomic nervous system involvement has been commonly encountered among the RA patients. Aim and Objectives: This study was aimed at investigating the various functions of the autonomic nervous system in RA patients and to explore the possible relation between the autonomic nervous system dysfunction with the patient’s age, gender, and disease duration and sero-positivity status of RA. Materials and methodology: This cross sectional study was conducted in a tertiary care hospital among 207 RA patients attending the Rheumatology clinic. Age matched control group included 106 persons. Two tests were used to assess the autonomic function namely the Tilt table test and Postural BP. Results: Although both parasympathetic and sympathetic divisions are affected in rheumatoid arthritis, parasympathetic division suffers more than the sympathetic division. None of our patients who showed an abnormal blood pressure response to tilting were suffered from the symptoms of orthostatic hypotension. Altered autonomic responses has shown significant positive correlation to female RA patients with longer disease duration and sero-positivity and does not show any relationship to the age of the patients. Conclusion: The early detection and treatment of autonomic neuropathy will not only help to reduce the mortality but also certainly improve the quality of life and reduce the sufferings in RA patients.
Keywords: Rheumatoid arthritis, Autonomic dysfunction, tilt table test, orthostatic hypotension.
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