title: Association between high sensitivity C-reactive protein, heart rate variability and corrected QT interval in patients with chronic inflammatory arthritis.
abstract: BACKGROUND
  The risk of sudden cardiac death is increased in chronic inflammatory arthritis, particularly rheumatoid arthritis (RA). To evaluate the putative effect of systemic inflammation on heart rate variability (HRV) and ventricular repolarization in chronic inflammatory arthritis, we analyzed in these patients the possible relationship among HRV parameters, QT interval, and high sensitivity C-reactive protein (hsCRP).
  
  
  METHODS
  One hundred-one patients with chronic inflammatory arthritis underwent a 15-minute ambulatory twelve-channel electrocardiogram-recording, to evaluate HRV and QT interval, as well as a venous withdrawal for hsCRP as an estimation of ongoing systemic inflammation.
  
  
  RESULTS
  In patients with chronic inflammatory arthritis, hsCRP is inversely correlated with HRV and directly with QTc duration, but while hsCRP is associated with HRV independently from any other investigated factor, the association between hsCRP and QTc seems to be an indirect consequence of the autonomic dysfunction itself. Within the whole cohort of patients, those subjects having elevated hsCRP levels displayed both a significant reduction in HRV and a prolongation of QTc with respect to patients with a normal hsCRP value. A similar, although less marked, degree of HRV depression and QTc prolongation was found in RA patients when compared to subjects with spondyloarthritis (SpA) and healthy controls.
  
  
  CONCLUSIONS
  These data provide evidence of a link between systemic inflammation and the arrhythmic risk in patients with chronic inflammatory arthritis, also putatively explaining, at least in part, how the different inflammatory load characterizing RA and SpA parallels the different risks of cardiovascular death in these two conditions.
authors.affiliation: Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy. lazzerini7@unisi.it
authors.forename: Pietro Enea
authors.initials: PE
authors.lastname: Lazzerini
authors.forename: Maurizio
authors.initials: M
authors.lastname: Acampa
authors.forename: Pier Leopoldo
authors.initials: PL
authors.lastname: Capecchi
authors.forename: Mohamed
authors.initials: M
authors.lastname: Hammoud
authors.forename: Silvia
authors.initials: S
authors.lastname: Maffei
authors.forename: Stefania
authors.initials: S
authors.lastname: Bisogno
authors.forename: Cristiana
authors.initials: C
authors.lastname: Barreca
authors.forename: Mauro
authors.initials: M
authors.lastname: Galeazzi
authors.forename: Franco
authors.initials: F
authors.lastname: Laghi-Pasini
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000503:physiopathology*; D001168:Arthritis / Q000150:complications / Q000503:physiopathology*; D002097:C-Reactive Protein / Q000032:analysis*; D002908:Chronic Disease; D004562:Electrocardiography / Q000379:methods; D005260:Female; D005583:Fourier Analysis; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D018709:Statistics, Nonparametric
chemical_list: D002097:C-Reactive Protein