Cardiovascular autonomic function assessed by autonomic function tests and serum autonomic neuropeptides in Egyptian children and adolescents with rheumatic diseases

Methods. Assessment of cardiovascular autonomic function was done in 20 lupus and 20 JIA patients, aged 816 years, by five non-invasive autonomic function tests (AFTs) and serum levels of neuropeptide Y (NPY) and vasoactive intestinal peptide (VIP), as indicators of sympathetic and parasympathetic functions, respectively, in comparison with 40 matched healthy control subjects. Results. Clinical evidence of CAN was found in 65 and 40 of lupus and JIA patients, respectively, and in none of healthy controls. Lupus and JIA patients had significantly lower serum NPY and VIP than controls (P 0.001). The five AFTs score had significant negative correlations to NPY and VIP (P 0.001). Patients with CAN had significantly lower serum NPY and VIP than patients without (P 0.001). Clinical evidence of CAN was found in 41.7 and 14.3 of asymptomatic lupus and JIA patients, respectively. There was significant positive association between CAN and important disease manifestations, including activity, in these patients. Conclusions. CAN is common in lupus and JIA patients, even in absence of relevant symptoms. Thus, assessments of cardiac autonomic function, by AFTs and serum autonomic neuropeptides (NPY and VIP), and the therapeutic effects of NPY and VIP are recommended in these patients.