Ann Rehabil Med.  2016 Apr;40(2):301-309. 10.5535/arm.2016.40.2.301.

Heart Rate Variability for Quantification of Autonomic Dysfunction in Fibromyalgia

• Kang JH
• Kim JK
• Hong SH
• Lee CH
• Choi BY

• KMID: 2309930
• DOI: http://doi.org/10.5535/arm.2016.40.2.301

Abstract

OBJECTIVE
To quantify autonomic dysfunction in fibromyalgia patients compared to healthy controls using heart rate variability (HRV).
METHODS
Sixteen patients with fibromyalgia and 16 healthy controls were recruited in this case control study. HRV was measured using the time-domain method incorporating the following parameters: total heartbeats, the mean of intervals between consecutive heartbeats (R-R intervals), the standard deviation of normal to normal R-R intervals (SDNN), the square root of the mean squared differences of successive R-R intervals (RMSSD), ratio of SDNN to RMSSD (SDNN/RMSSD), and difference between the longest and shortest R-R interval under different three conditions including normal quiet breathing, rate controlled breathing, and Valsalva maneuver. The severity of autonomic symptoms in the group of patients with fibromyalgia was measured by Composite Autonomic Symptom Scale 31 (COMPASS 31). Then we analyzed the difference between the fibromyalgia and control groups and the correlation between the COMPASS 31 and aforementioned HRV parameters in the study groups.
RESULTS
Patients with fibromyalgia had significantly higher SDNN/RMSSD values under both normal quiet breathing and rate controlled breathing compared to controls. Differences between the longest and shortest R-R interval under Valsalva maneuver were also significantly lower in patients with fibromyalgia than in controls. COMPASS 31 score was negatively correlated with SDNN/RMSSD values under rate controlled breathing.
CONCLUSION
SDNN/RMSSD is a valuable parameter for autonomic nervous system function and can be used to quantify subjective autonomic symptoms in patients with fibromyalgia.

Keyword

Fibromyalgia; Autonomic nervous system; Heart rate; Sympathetic nervous system; Parasympathetic nervous system

MeSH Terms

Autonomic Nervous System
Case-Control Studies
Fibromyalgia*
Heart Rate*
Heart*
Humans
Parasympathetic Nervous System
Respiration
Sympathetic Nervous System
Valsalva Maneuver

Figure

• 

  Fig. 1 Correlation between COMPASS 31 and ratio of SDNN to RMSSD (SDNN/RMSSD) under rate controlled breathing. Linear regression analysis was used to determine the relation between COMPASS 31 (y-axis) and SDNN/RMSSD (x-axis). (A) No significant correlation under normal quiet breathing (p=0.756). (B) Significant negative correlation was revealed under rate controlled breathing (y=-10.562x+61.629, R=0.546, p=0.029). COMPASS 31, Composite Autonomic Symptom Scale 31; SDNN, standard deviation of normal to normal R-R intervals; RMSSD, square root of the mean squared differences of successive R-R intervals.

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