Evidence map›Paper›PMID 41523445›Full record

ArticleCureus2025

Heart Rate Variability and Intrinsic Autonomic Coupling in Ehlers-Danlos Syndrome.

Waqas Alauddin, Prajakta M Radke, Nithya Janardhana, Ishita Singh, Ayush Sharma, Shashwat Arora, Brishabh R Prajesh, Rishika Shree, Zaki Shaikh

Abstract read
In one paragraph

Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Waqas AlauddinPhysiology, Naraina Medical College and Research Centre, Kanpur, IND.
Prajakta M RadkePhysiology, Mahatma Gandhi Mission Medical College, Nerul, IND.
Nithya JanardhanaMedicine, Adichunchanagiri Institute of Medical Sciences, Karnataka, IND.
Ishita SinghMedicine, Lala Lajpat Rai Memorial Medical College, Meerut, IND.
Ayush SharmaMedicine, Amar Shaheed Jodha Singh Atayiya Thakur Dariyao Singh Medical College, Fatehpur, IND.
Shashwat AroraMedicine, Naraina Medical College and Research Centre, Kanpur, IND.
Brishabh R PrajeshPhysiology, Naraina Medical College and Research Centre, Kanpur, IND.
Rishika ShreePhysiology, Naraina Medical College and Research Centre, Kanpur, IND.
Zaki ShaikhPhysiology, Mahatma Gandhi Mission Medical College, Nerul, IND.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background Ehlers-Danlos syndrome (EDS) encompasses a group of connective tissue disorders often extending beyond musculoskeletal involvement. Emerging evidence indicates a high prevalence of cardiovascular autonomic dysfunction in this population, yet systematic physiologic evaluations remain limited. Objective To characterize cardiovascular autonomic function in EDS using standardized autonomic testing and heart rate variability (HRV) indices, and to explore intrinsic autonomic coupling by correlating resting heart rate with HRV parameters. Methods This cross-sectional study included 30 clinically diagnosed patients with EDS and 30 age- and sex-matched healthy controls. Short-term HRV analysis (five-minute supine ECG) and standard autonomic testing, including head-up tilt, were performed under controlled laboratory conditions. HRV indices were derived using Fast Fourier Transform (FFT) algorithms. Group differences were evaluated with independent t-tests, and correlations between resting heart rate and HRV measures were analyzed using Pearson's correlation. Results Compared with controls, patients with EDS exhibited higher resting heart rate (87.3±11.6 vs 75.2±9.8 bpm), lower parasympathetic time-domain indices (standard deviation of normal-to-normal intervals or SDNN 35.4±9.7 vs 49.1±11.4 ms; root mean square of successive differences (RMSSD; 20.7±6.9 vs 31.6±8.8 ms), and altered frequency-domain markers (low frequency (LF) power 671±205 vs 542±176 ms²; high frequency (HF) power 174±81 vs 272±106 ms²; LF/HF ratio 3.7±1.3 vs 1.8±0.7). Orthostatic intolerance was observed in 16 (53.3%) of the patients with EDS versus three (10%) of the controls. Correlation analysis revealed that in EDS, resting HR correlated negatively with SDNN (r=-0.45, p=0.01), RMSSD (r=-0.52, p<0.01), and HF power (r=-0.39, p=0.03), while showing a positive correlation with LF/HF ratio (r=0.58, p<0.001). Conclusion Patients with EDS had autonomic dysregulation, with sympathetic predominance and diminished vagal modulation. The intrinsic coupling between resting heart rate and HRV indices suggests impaired cardiovascular autonomic integration. HRV profiling is a valuable noninvasive biomarker for early identification and longitudinal monitoring of autonomic dysfunction in EDS, potentially enhancing disease characterization and guiding individualized therapeutic strategies.

Indexed as

autonomic nervous systemcardiovascular autonomic dysfunctiondysautonomiaehlers-danlos syndromeheart rate variabilityorthostatic intoleranceparasympathetic nervous systemparasympathetic tonepostural tachycardia syndromesympathetic nervous system

Identifiers

PMID41523445
PMCPMC12781037

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.