Arthritis & Rheumatism, Volume 60,
October 2009 Abstract Supplement

The 2009 ACR/ARHP Annual Scientific Meeting
Philadelphia October 16-21, 2009.


Autonomic Nervous Dysfunction Development in Patients with Primary Sjgrens Syndromea 5 Year Follow-up

Mandl,  Thomas

Purpose:

To investigate autonomic nervous dysfunction development over a 5-year period in patients with primary Sjögren's syndrome (pSS).

Materials:

15 pSS patients, previously studied for autonomic dysfunction, were included. Autonomic nervous function test (ANT) and Autonomic Symptom Profile (ASP) controls consisted of 56/80/238/200 previously investigated individuals.

Methods:

The patients were studied at baseline and after a 5 year follow-up by 5 ANTs (deep-breathing test (E/I-ratio), orthostatic heart rate test (AI), finger-skin blood flow test (VAC-index), and orthostatic blood pressure test (SBP & DBP-ratios)). Patients also filled out the ASP questionnaire on autonomic dysfunction symptoms.

Results:

The E/I-ratio and SBP- & DBP-ratios were decreased in pSS patients both at baseline and follow-up.The orthostatic intolerance, urinary dysfunction, gastroparesis, secretomotor, pupillomotor and ASP total score were increased in pSS patients both at baseline and at follow-up. When comparing ANT and ASP results between baseline and at follow-up, the E/I- and DBP-ratios were decreased and the vasomotor score increased at follow-up.

Conclusion:

Both objective and subjective signs of a parasympathetic and a sympathetic dysfunction were seen in pSS patients at baseline and after a 5 year follow-up. The E/I- and DBP-ratios and vasomotor score were found to significantly deteriorate during the 5-year follow-up.

Table 1. Results of the ANTs and ASP, at baseline and after a 5 year follow-up. ANT results were age-corrected and expressed as z-scores (SD). Most ASP scores were age-, gender-, height- and weight-corrected and expressed as z-scores (SD).

 pSS patients BaselinepSS patients Year 5Controlsp-value pSS patients Baseline vs Year 5
ANT    
E/I-ratio-0.82 (-1.30, 0.07)*-1.32 (-1.76, -0.67)**-0.25 (-0.62, 0.60)0.04
AI-0.14 (-1.32, 0.33)0.15 (-0.94, 1.10)0.03 (-0.67, 0.65)0.09
VAC-index0.54 (-0.85, 1.61)0.39 (0.02, 1.48)*0.09 (-0.67, 0.62)0.38
SBP-ratio-0.96 (-1.96, -0.06)**-0.88 (-1.28, 0.64)*0.00 (-0.61, 0.70)0.26
DBP-ratio-0.76 (-1.05, -0.22)**-2.46 (-3.04, -1.64)***0.00 (-0.47, 0.54)0.00
ASP    
Orthostatic intol1.21 (-0.64, 2.46)*1.25 (0.22, 2.54)**-0.39 (-0.78, 0.79)0.83
Urinary0.29 (-0.49, 2.34)*0.12 (-0.45, 2.73)**-0.51 (-0.71, 0.32)0.25
Gastroparesis0.75 (0.00, 1.50)*0.00 (0.00, 1.50)*0.00 (0.00, 0.00)0.61
Autonomic diarrhea0.62 (-0.51, 1.90)0.65 (-0.52, 2.10)-0.42 (-0.60, 0.68)0.88
Constipation0.45 (-0.54, 2.65)1.05 (-0.54, 2.65)-0.30 (-0.52, -0.18)0.86
Secretomotor2.30 (2.12, 4.66)***4.25 (2.11, 5.07)***-0.45 (-0.72, 0.52)0.98
Pupillomotor1.57 (-0.24, 3.23)**1.73 (0.48, 3.07)***-0.42 (-0.71, 0.55)0.88
Vasomotor-0.45 (-0.56, 2.39)-0.26 (-0.54, 2.71)-0.33 (-0.49, -0.20)0.02
Reflex syncope0.00 (0.00, 0.00)0.00 (0.00, 0.00)0.00 (0.00, 0.00)0.32
Sleep disorder-0.42 (-0.83, 1.17)0.44 (-0.16, 1.67)*-0.05 (-0.79, 0.35)0.22
Total score1.92 (0.40, 3.32)***2.44 (0.90, 3.11)***-0.21 (-0.82, 0.72)0.51

To cite this abstract, please use the following information:
Mandl, Thomas; Autonomic Nervous Dysfunction Development in Patients with Primary Sjgrens Syndromea 5 Year Follow-up [abstract]. Arthritis Rheum 2009;60 Suppl 10 :484
DOI: 10.1002/art.25566

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