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Assessment of autonomic dysfunction with the COMPASS-31 and its relationship with disease activity and cardiovascular risks in patients with psoriatic arthritis

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Abstract

This study aimed to evaluate the autonomic dysfunction as assessed by the Composite Autonomic Symptom Score-31 (COMPASS-31) as well as its relationship with disease activity and cardiovascular risks in patients with psoriatic arthritis (PsA). This cross-sectional observational study involved 118 PsA patients (85 females, mean age 45.6 years) and 64 healthy subjects. Cardiovascular risks were recorded including body mass index (BMI), hypertension (HT), diabetes mellitus (DM), dyslipidemia, metabolic syndrome (MetS), and 10-year Framingham Risk scores (FRS) were calculated. PsA was assessed with regard to disease activity, quality of life, and function. Autonomic dysfunction was evaluated using the COMPASS-31 consisting of six subdivisions including orthostatic, vasomotor, secretomotor, gastrointestinal, bladder, and pupillomotor functions. The mean disease duration was 63.3 months. The mean total COMPASS-31 score was significantly higher in PsA patients than in controls (24.4 vs 11.1; p < 0.001), as were all sub-domain scores. COMPASS-31 scores were significantly lower in patients with DAPSA-REM and MDA. The COMPASS-31 total score showed significant correlations with scores of pain, global assessment, fatigue, function, quality of life, DAPSA, and BASDAI (p < 0.05).The presence of HT, dyslipidemia, MetS, and abdominal obesity did not significantly affect the total COMPASS-31 and sub-domain scores, except for the secretomotor scores being significantly higher in patients with abdominal obesity and MetS (p < 0.05). COMPASS-31 scores were not significantly different across the FRS risk groups. The symptoms of autonomic dysfunction are prevalent in PsA patients. High disease activity and pain have negative effects on autonomic function, and also functional impairment, fatigue, and poor quality of life are associated with autonomic dysfunction. However, the COMPASS-31 was found to be insufficient to demonstrate a clear relationship between autonomic dysfunction and cardiovascular risk.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Rheumatology, Ümraniye Training and Research Hospital, Adem yavuz Street, 34764, Istanbul, Turkey

    Halise Hande Gezer

  2. Department of Rheumatology, Prof. Dr. Cemil Taşçıoğlu City Hospital, Istanbul, Turkey

    Didem Erdem Gürsoy

  3. Department of Rheumatology, Kartal Lütfi Kirdar City Hospital, Istanbul, Turkey

    Sevtap Acer Kasman

  4. Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Marmara University School of Medicine, Istanbul, Turkey

    Mehmet Tuncay Duruöz

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  1. Halise Hande Gezer
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  2. Didem Erdem Gürsoy
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  3. Sevtap Acer Kasman
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  4. Mehmet Tuncay Duruöz
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Contributions

All authors contributed to the study’s conception, design, and data collection. HHG, DEG, SAK and MTD performed material preparation and analysis. HHG wrote the first draft of the manuscript and all authors commented on previous versions. All co-authors are fully responsible for all aspects of the study and the final manuscript in line with the IJME 4 criteria. All co-authors satisfy all four criteria (participated in study design, data collection, analysis, interpretation and writing equally), and take full responsibility for the integrity of the study and the final manuscript.

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Correspondence to Halise Hande Gezer.

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All procedures performed in studies involving human participants were performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Ethical approval was taken from the Marmara University Ethics Committee on 09.2019. The protocol number was 41.

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Gezer, H.H., Erdem Gürsoy, D., Acer Kasman, S. et al. Assessment of autonomic dysfunction with the COMPASS-31 and its relationship with disease activity and cardiovascular risks in patients with psoriatic arthritis. Rheumatol Int 42, 1539–1548 (2022). https://doi.org/10.1007/s00296-022-05110-7

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