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Cardiovascular Reactivity in Fibromyalgia: Evidence for Pathogenic Heterogeneity
JOCHANAN E. NASCHITZ, MICHAEL ROZENBAUM, MADELINE C. FIELDS, SEAN ENIS, HAGIT MANOR, DANIEL DREYFUSS, SHANNON PECK, ELIZABETH RUBIN PECK, JAY P. BABICH, EDWARD P. MINTZ, EDMOND SABO, GLEB SLOBODIN, and ITZHAK ROSNER
ABSTRACT. Methods. The study group included 30 women with FM, average age 46.7 years (SD 7.03). An age matched group of 30 women with other rheumatic disorders or having a dysautonomic background [chronic fatigue syndrome (CFS), non-CFS fatigue, neurally mediated syncope, and psoriatic arthritis (PsA)] served as controls. Subjects were evaluated with a head-up tilt test with beat-to-beat recording of the heart rate (HR) and pulse transit time. A 10-minute supine phase was followed by 600 cardiac cycles recorded on tilt. Data were processed by recurrence plot and fractal analysis. Variables acting as independent predictors of the cardiovascular reactivity were identified in FM patients versus controls. Results. No statistically significant differences were found between the groups by univariate analysis comparing 92 variables of cardiovascular reactivity in FM patients compared to controls. Conclusion. Study of cardiovascular reactivity utilizing a head-up tilt test and processing the data using the FRAS method did not reveal a specific FM-associated abnormality. Our data confirm studies that utilized other methodologies and reached similar conclusions. Patients with FM represent a heterogenous group with respect to their pattern of cardiovascular reactivity. (J Rheumatol 2005; 32:335-9) Key Indexing Terms:
FIBROMYALGIA From the Departments of Internal Medicine A and Rheumatology, Bnai Zion Medical Center and Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel. J.E. Naschitz, MD, Associate Professor of Medicine, Department of Internal Medicine; M. Rozenbaum, MD, Department of Rheumatology; M.C. Fields, MD; S. Enis, MD; H. Manor, MD; D. Dreyfuss, MD; S. Peck, MD; E. Rubin Peck, MD; J.P. Babich, MD; E.P. Mintz, MD; E. Sabo, MD, Lecturer; G. Slobodin, MD, Department of Internal Medicine; I. Rosner, MD, Senior Lecturer, Department of Rheumatology. Address reprint requests to Dr. J.E. Naschitz, Department of Internal Medicine A, Bnai Zion Medical Center, Haifa 31048, PO Box 4940, Israel. E-mail: Naschitz@tx.technion.ac.il Submitted February 16, 2004; revision accepted September 16, 2004. |