Correlation between Cardiovascular Autonomic and Pulmonary Ventilation Functions in Myasthenia Gravis Patients
Abstract
:Highlights
- A lower baroreflex sensitivity in the MG group was associated with worse clinical disease outcomes and reduced pulmonary function.
- Age, forced vital capacity, and total lung capacity could predict the heart rate response during deep breathing.
- There is a significant relationship between reduced pulmonary ventilation function or respiratory mechanics and cardiovascular autonomic parameters in MG patients.
- Future studies should prioritize investigating how respiratory and autonomic function testing interact, alongside exploring the impact of pulmonary rehabilitation.
Abstract
1. Introduction
2. Material and Methods
2.1. Pulmonary Function Tests (PFTs)
2.2. Cardiovascular Autonomic Testing
2.3. Statistical Analysis
3. Results
3.1. Demographic and Clinical Data
3.2. Pulmonary Function Tests: MG Patients vs. HCs
3.3. Autonomic Function
3.4. Relationship between Cardiovascular Autonomic, Pulmonary Function Parameters, and Clinical Disease Outcomes
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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HCs | Total MG | p-Value | |
---|---|---|---|
Number of subjects | 22 | 22 | |
Sex, female n (%) | 16 (77.73) | 17 (77.27) | 0.727 |
BMI, mean (kg/m2) | 23.66 ± 3.82 | 25.42 ± 4.34 | 0.160 |
Age, mean (years) | 37.32 ± 12.17 | 42.45 ± 7.19 | 0.096 |
Age at first manifestation, mean (years) | 35.32 ± 9.42 | ||
Disease duration (years), mean (range) | 6.93 ± 8.02 | ||
Seropositivity to AChR antibodies, n (%) | 9 (40.9) | ||
Seropositivity to MuSK antibodies, n (%) | 4 (18.2) | ||
Seropositivity to AChR and MuSK, antibodies, n (%) | 1 (4.54) | ||
Type of MG, n (%) | |||
Ocular | 1 (4.5) | ||
Generalized | 21 (95.5) | ||
Thymectomy, n (%) | 7 (22) | ||
Severity of disease at the moment of testing (MGFA, number, %) | |||
Class 0 | 0 (0) | ||
Class I (ocular) | 1 (4.5) | ||
Class IIa | 9 (40.9) | ||
Class IIIa | 12 (54.5) | ||
Histology changes, n (%) | |||
Thymic pathology | 14 (63.6) | ||
Thymoma | 1 (4.5) | ||
Unknown | 1 (4.5) | ||
Type of treatment, n (%) | |||
Use of cholinesterase inhibitors | 21 (95.5) | ||
Use of corticosteroids | 13 (59.1) | ||
Use of immunosuppressants | 8 (36.4) |
MG | HCs | p | |||
---|---|---|---|---|---|
Pulmonary Volume | Mean | Median [Q1–Q3] | Mean | Median [Q1–Q3] | |
VC (L) | 3.67 | 3.60 [2.91–4.22] | 4.28 | 4.22 [3.59–4.70] | 0.037 |
VC (%pred) | 94.12 | 94.50 [83.00–110.00] | 105.95 | 107.00 [99.00–115.0] | 0.059 |
IC (L) | 2.65 | 2.46 [2.01–3.02] | 3.01 | 2.80 [2.37–3.55] | 0.192 |
IC (%pred) | 101.77 | 96.50 [90.00–109.00] | 106.73 | 108.50 [98.00–115.00] | 0.124 |
RV (L) | 1.98 | 2.13 [1.57–2.41] | 1.92 | 1.82 [1.48–2.07] | 0.753 |
RV (%pred) | 114.23 | 110.50 [99.00–132.00] | 110.50 | 107.00 [91.00–129.00] | 0.737 |
TLC (L) | 5.59 | 4.96 [4.75–6.39] | 6.21 | 5.93 [5.50–6.80] | 0.139 |
TLC (%pred) | 101.32 | 96.00 [91.00–103.00] | 106.73 | 105.50 [99.00–115.00] | 0.262 |
RV/TLC | 35.70 | 36.53 [31.82–41.16] | 30.69 | 29.31 [24.90–36.49] | 0.093 |
RV/TLC (%pred) | 109.64 | 113 [94.00–128.00] | 97.59 | 95.00 [87.00–112.00] | 0.129 |
Pulmonary diffusing capacity | |||||
DLCO (mmol/min/kPa) | 7.90 | 7.14 [6.01–8.87] | 8.55 | 8.44 [7.70–9.59] | 0.252 |
DLCO (%pred) | 84.53 | 85.00 [75.00–91.00] | 88.95 | 90.00 [80.00–95.00] | 0.315 |
KCO (mmol/min/kPa/L) | 1.53 | 1.58 [1.40–1.72] | 5.28 | 1.59 [1.40–1.75] | 0.410 |
KCO (%pred) | 91.60 | 98.00 [84.00–100.00] | 93.05 | 92.00 [83.00–105.00] | 0.843 |
Pulmonary ventilation | |||||
FVC (L) | 3.70 | 3.57 [3.17–4.19] | 4.52 | 4.31 [3.97–5.29] | 0.051 |
FVC (%pred) | 104.05 | 91.50 [80.00–99.00] | 110.86 | 113.00 [108.00–115.00] | 0.021 |
FEV1 (L) | 2.84 | 2.74 [2.54–3.35] | 3.50 | 3.34 [3.03–3.90] | 0.011 |
FEV1 (%pred) | 85.86 | 90.00 [80.00–96.00] | 98.23 | 99.00 [94.00–104.00] | 0.010 |
FEV1/FVC ratio (%) | 76.58 | 79.02 [75.64–82.01] | 80.16 | 78.95 [76.43–86.50] | 0.379 |
FEV1/FVC (%pred) | 93.64 | 97.50 [91.00–100.00] | 96.73 | 96.50 [93.00–100.00] | 0.760 |
FEV1/VCmax | 72.93 | 75.07 [72.93–76.95] | 77.90 | 77.21 [73.14–81.65] | 0.193 |
FEV1/VCmax% | 90.27 | 92.00 [90.00–97.00] | 95.45 | 95.50 [89.00–100.00] | 0.302 |
Respiratory mechanics | |||||
PEF (L/s) | 5.68 | 5.67 [4.55–6.68] | 6.53 | 6.27 [5.58–7.40] | 0.163 |
PEF (%pred) | 77.82 | 77.50 [67.00–88.00] | 84.86 | 82.00 [73.00–97.00] | 0.282 |
MEF50 (L/s) | 3.47 | 3.34 [2.86–4.59] | 4.23 | 3.91 [3.43–4.55] | 0.055 |
MEF50 (%pred) | 79.64 | 82.50 [68.00–94.00] | 91.55 | 8.50 [73.00–105.00] | 0.113 |
MIF50(L/s) | 4.21 | 4.41 [3.36–5.07] | 4.85 | 4.62 [3.98–5.39] | 0.149 |
PIF (L/s) | 4.40 | 4.43 [3.43–5.27] | 4.92 | 4.72 [4.32–5.32] | 0.187 |
sRAW (kPa × s) | 0.94 | 0.88 [0.72–1.09] | 1.04 | 1.09 [0.72–1.34] | 0.336 |
sRAW (%pred) | 93.50 | 86.50 [67.00–102.00] | 102.32 | 107.50 [75.00–124.00] | 0.296 |
RAWtot (kPa × s/L) | 0.30 | 0.26 [0.21–0.34] | 0.31 | 0.27 [0.25–0.33] | 0.805 |
sRAWtot (kPa × s/L) | 98.73 | 84.00 [71.00–114.00] | 103.91 | 87.50 [82.00–109.00] | 0.664 |
MG | HCs | p | |
---|---|---|---|
Breathing rate (bpm) | 17.27 [14.49–19.22] | 16.21 [15.04–18.22] | 0.263 |
HR (1/min) | 65.44 [62.35–65.44] | 62.64 [59.30–67.92] | 0.826 |
LF-RRI (ms2) | 418.19 [306.76–1138.21] | 1014.71 [322.75–1539.50] | 0.136 |
HF-RRI (ms2) | 235.30 [73.16–493.67] | 463.76 [191.16–884.74] | 0.038 |
PSD-RRI (ms2) | 1047.04 [530.97–2565.85] | 2647.00 [810.82–3824.54] | 0.040 |
LF/HF-RRI (1) | 2.14 [1.15–4.66] | 1.91 [0.99–3.35] | 0.307 |
LF/HF (1) | 1.88 [0.95–2.84] | 1.05 [0.85–2.12] | 0.113 |
E/I ratio | 1.19 [1.12–1.29] | 1.21 [1.17–1.36] | 0.058 |
Valsalva ratio | 1.32 [1.11–1.47] | 1.32 [1.20–1.70] | 0.337 |
BRS (ms/mmHg) | 13.45 [9.06–17.99] | 20.05 [12.70–27.70] | 0.037 |
Parasympathetic dysfunction (%) | 27.27 | 4.55 | 0.047 |
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Zawadka-Kunikowska, M.; Rzepiński, Ł.; Cieślicka, M.; Fanslau, J.; Klawe, J.J.; Tafil-Klawe, M. Correlation between Cardiovascular Autonomic and Pulmonary Ventilation Functions in Myasthenia Gravis Patients. Adv. Respir. Med. 2023, 91, 546-559. https://doi.org/10.3390/arm91060040
Zawadka-Kunikowska M, Rzepiński Ł, Cieślicka M, Fanslau J, Klawe JJ, Tafil-Klawe M. Correlation between Cardiovascular Autonomic and Pulmonary Ventilation Functions in Myasthenia Gravis Patients. Advances in Respiratory Medicine. 2023; 91(6):546-559. https://doi.org/10.3390/arm91060040
Chicago/Turabian StyleZawadka-Kunikowska, Monika, Łukasz Rzepiński, Mirosława Cieślicka, Joanna Fanslau, Jacek J. Klawe, and Małgorzata Tafil-Klawe. 2023. "Correlation between Cardiovascular Autonomic and Pulmonary Ventilation Functions in Myasthenia Gravis Patients" Advances in Respiratory Medicine 91, no. 6: 546-559. https://doi.org/10.3390/arm91060040