Correlation Between Heart Rate Variability Parameters and Circulating Neuropeptides in Fibromyalgia

Laura Aline Martínez-Martínez¹, Claudia Lerma Gonzalez ², María del Carmen Navarro Gonzalez ³, Oscar Infante Vázquez ⁴, Felipe Israel López Trejo ⁵, Evelyn Aranda Cano ⁵, Alfonso Salgado Aguayo ³, Daniel Paz Gómez ³, María Isabel Barrera Villalpando ⁶, Luis Silveira ⁷, Violeta Higuera Ortiz ⁸, Angélica Vargas Guerrero ⁵ and Manuel Martínez-Lavín ⁹, ¹Departamento de Reumatologia del Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico, ²Departamento de Instrumentación del Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico, ³Laboratorio de Investigación en Enfermedades Reumáticas del Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico, ⁴Departamento de Instrumentación del Instituto Nacional de Cardiología Ignacio Chávez, Mexico Ciity, Mexico, ⁵Departamento de Reumatología del Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico, ⁶Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico, ⁷Departamento de Reumatología, Instituto Nacional de Cardiología "Ignacio Chávez", Ciudad de México, México., Mexico, Mexico, ⁸Hospital General de Zona y Medicina Familiar 8 del Instituto Mexicano del Seguro Social, Mexico City, Mexico, ⁹Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: beta-endorphin and neurotensin, fibromyalgia, heart rate variability, neuropeptides

Session Information

Date: Sunday, November 10, 2019

Title: Fibromyalgia & Other Clinical Pain Syndromes Poster

Session Type: Poster Session (Sunday)

Session Time: 9:00AM-11:00AM

Background/Purpose: Heart rate variability analyses in fibromyalgia patients have shown changes consistent with sympathetic hyperactivity that theoretically could lead to chronic pain. There is little investigation on dysautonomia associated circulating neuropeptides in fibromyalgia. There are no studies correlating serum neuropeptide levels with heart rate variability parameters. The purpose of this study was to measure dysautonomia-associated serum neuropeptides levels in women with fibromyalgia and in age, sex, body mass index comparable healthy controls. Additionally to correlate neuropeptide levels with heart rate variability parameters and disease severity.

Methods: We studied 23 women with fibromyalgia without comorbid conditions and 15 matched healthy controls. At the time of the study, patients were free from medications that could affect autonomic-related neuropeptide levels. Time domain parameters were extracted from 24 hours heart rate variability recording. All participants filled out the Revised Fibromyalgia Impact Questionnaire (FIQR), Widespread Pain Index (WPI), Symptom Severity Scale (SSS), Polysymptomatic Distress Scale (PDS) and the Small Fiber Neuropathy Symptoms Survey (SFNSS). The following 7 neuropeptides levels were measured using the 7-Plex Human Neuropeptide Magnetic KitMilliplex MAP: aMSH, beta-endorphin, cortisol, neurotensin, orexin, oxytocin and substance P. The protocol was approved by the institution review board and required a written informed consent from participants. Kolmorogov-Smirnov test was used for normality analysis, Student’s T test or Mann Whitney U test for comparisons and Pearson or Spearmen test for correlations. SPSS version 23.0 was used for the analyses.

Results: Beta-endorphin (669.24 ± 186.28 vs 541.71 ± 146.26pg/ml, p=0.028) and neurotensin (156.23 ± 58.15 vs 116.64 ± 47.93pg/ml, p=0.016) levels were higher in fibromyalgia patients. Both neuropeptides levels had a negative correlation with heart rate RR interval standard deviation (Rho -0.5 and Rho -0.6, p< 0.05) and with FIQR “tenderness to touch” (Rho -0.4 and Rho -0.4, p< 0.05).

Conclusion: Heart rate variability parameters suggesting sympathetic hyperactivity correlate with circulating beta-endorphin and neurotensin levels in fibromyalgia patients. Future research will define the possible clinical implications of this novel finding.

Disclosure: L. Martínez-Martínez, None; C. Lerma Gonzalez, None; M. Navarro Gonzalez, None; O. Infante Vázquez, None; F. López Trejo, None; E. Aranda Cano, None; A. Salgado Aguayo, None; D. Paz Gómez, None; M. Barrera Villalpando, None; L. Silveira, None; V. Higuera Ortiz, None; A. Vargas Guerrero, None; M. Martínez-Lavín, None.

To cite this abstract in AMA style:

Martínez-Martínez L, Lerma Gonzalez C, Navarro Gonzalez M, Infante Vázquez O, López Trejo F, Aranda Cano E, Salgado Aguayo A, Paz Gómez D, Barrera Villalpando M, Silveira L, Higuera Ortiz V, Vargas Guerrero A, Martínez-Lavín M. Correlation Between Heart Rate Variability Parameters and Circulating Neuropeptides in Fibromyalgia [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/correlation-between-heart-rate-variability-parameters-and-circulating-neuropeptides-in-fibromyalgia/. Accessed .

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