Chronotropic Incompetence and Reduced Heart Rate Recovery in Rheumatoid Arthritis

Autor(es)

Pecanha, Tiago ; Rodrigues, Reynaldo ; Pinto, Ana Jessica ; Sa-Pinto, Ana Lucia ; Guedes, Lissiane ; Bonfiglioli, Karina ; Gualano, Bruno ; Roschel, Hamilton

• Tipo de documento: Artigo Científico
• Fonte: JCR-JOURNAL OF CLINICAL RHEUMATOLOGY; v. 24, n. 7, p. 375-380, OCT 2018.
• Citações Web of Science: 0

Resumo

Background/Objective Recent studies have indicated that cardiac autonomic dysfunction is an early sign of cardiovascular impairment in rheumatoid arthritis (RA). Previous studies have mainly focused on resting assessments; however, analysis of heart rate (HR) responses to exercise might provide additional information on cardiac autonomic dysfunction in this disease. Thus, we aimed to assess the HR responses during and after a maximal graded exercise test in patients with RA and healthy controls (CONs). Methods This was a cross-sectional study in which 27 female RA patients and 14 female CONs frequency matched by physical activity, age, and body mass index were compared for HR responses during and after a maximal graded exercise test. Results Rheumatoid arthritis patients showed reduced chronotropic response (94.3% 16.3% vs. 106.1% +/- 10.3%, p = 0.02) and lower HR recovery (HRR) at 30 seconds (8.6 +/- 6.7 vs. 13.4 +/- 5.2 beats/min {[}bpm], p = 0.02), 60 seconds (16.5 +/- 7.8 vs. 24.0 +/- 9.9 bpm, p = 0.01), 120 seconds (32.6 +/- 9.9 vs. 40.7 +/- 12.3 bpm, p = 0.03), and 180 seconds (46.5 +/- 12.6 vs. 55.5 +/- 13.4 bpm, p = 0.05) post-maximal exercise test when compared with CONs. Moreover, the prevalence of chronotropic incompetence (i.e., failure to reach 80% of the HR-predicted response) and abnormal HRR (i.e., HRR 12 bpm) were, respectively, 22.2% and 37.1% in RA patients. Conclusions Patients with RA showed reduced chronotropic response to exercise and slower postexercise HRR. These abnormal autonomic responses to exercise indicate the presence of cardiac autonomic dysfunction and increased cardiovascular risk in this population. (AU)

• Processo FAPESP: 15/26937-4 - Estudos sobre (in)atividade física em pacientes com artrite reumatóide: caracterização, associações com a doença e efeitos da interrupção do tempo sedentário
• Beneficiário: Ana Jéssica Pinto
• Modalidade de apoio: Bolsas no Brasil - Doutorado Direto
• Processo FAPESP: 16/23319-0 - Disfunção autonômica cardiovascular em pacientes com artrite reumatoide: caracterização, associações com a doença e efeitos da interrupção do tempo sedentário
• Beneficiário: Tiago Peçanha de Oliveira
• Modalidade de apoio: Bolsas no Brasil - Pós-Doutorado