title: Heart-rate recovery index is impaired in Behçet's disease.
abstract: Behçet's disease, a multisystemic inflammatory disorder, has been associated with a number of cardiovascular dysfunctions, including ventricular arrhythmias and sudden cardiac death. Heart-rate recovery after exercise can provide both an estimate of impaired parasympathetic tone and a prognosis in regard to all-cause and cardiovascular death. The aim of our study was to evaluate heart-rate recovery in Behçet's disease. From January through July 2008, we examined at our outpatient clinic and prospectively enrolled 30 consecutive patients with Behçet's disease and 50 healthy control participants who were matched for age and sex. Basal electrocardiography, echocardiography, and treadmill exercise testing were performed in all patients and control participants. The heart-rate recovery index was calculated in the usual manner, by subtracting the 1st-minute (Rec1), 2nd-minute (Rec2), and 3rd-minute (Rec3) recovery heart rates from the maximal heart rate after exercise stress testing. Patients with Behçet's disease exhibited significantly lower heart-rate recovery numbers, compared with healthy control participants: Rec1, 24.28 +/- 8.2 vs 34.4 +/- 7.6, P = 0.002; Rec2, 49.28 +/- 11.2 vs 57.5 +/- 7.0, P < 0.05; and Rec3, 56.2 +/- 12.11 vs 67.4 +/- 8.7, P = 0.014. To our knowledge, this is the 1st study that shows an impaired heart-rate recovery index (indicative of reduced parasympathetic activity) among patients with Behçet's disease. Given the independent prognostic value of the heart-rate recovery index, our results may explain the increased occurrence of arrhythmias and sudden cardiac death in Behçet's patients. Therefore, this index may be clinically useful in the identification of high-risk patients.
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Altindag 06100, Ankara, Turkey.
authors.forename: Ergun Baris
authors.initials: EB
authors.lastname: Kaya
authors.forename: Hikmet
authors.initials: H
authors.lastname: Yorgun
authors.forename: Ali
authors.initials: A
authors.lastname: Akdogan
authors.forename: Ahmet Hakan
authors.initials: AH
authors.lastname: Ates
authors.forename: Ugur
authors.initials: U
authors.lastname: Canpolat
authors.forename: Hamza
authors.initials: H
authors.lastname: Sunman
authors.forename: Kudret
authors.initials: K
authors.lastname: Aytemir
authors.forename: Lale
authors.initials: L
authors.lastname: Tokgozoglu
authors.forename: Giray
authors.initials: G
authors.lastname: Kabakci
authors.forename: Meral
authors.initials: M
authors.lastname: Calguneri
authors.forename: Hilmi
authors.initials: H
authors.lastname: Ozkutlu
authors.forename: Ali
authors.initials: A
authors.lastname: Oto
mesh_terms: D000328:Adult; D001528:Behcet Syndrome / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000503:physiopathology; D016022:Case-Control Studies; D004452:Echocardiography; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D010275:Parasympathetic Nervous System / Q000503:physiopathology; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D020127:Recovery of Function; D018570:Risk Assessment; D013997:Time Factors
references.citation: Am J Cardiol. 2002 Oct 15;90(8):848-52
references.pmid: 12372572
references.citation: Jpn Heart J. 2002 Jul;43(4):389-98
references.pmid: 12227714
references.citation: Eur Heart J. 1990 Oct;11(10):957-9
references.pmid: 2265646
references.citation: J Neurol. 1998 Apr;245(4):197-205
references.pmid: 9591220
references.citation: Diabetes. 2002 Mar;51(3):803-7
references.pmid: 11872683
references.citation: J Am Coll Cardiol. 1994 Nov 15;24(6):1529-35
references.pmid: 7930286
references.citation: Lancet. 2002 May 4;359(9317):1536-7
references.pmid: 12047958
references.citation: Ann Rheum Dis. 1997 Mar;56(3):205-8
references.pmid: 9135228
references.citation: J Rheumatol. 1982 Jul-Aug;9(4):630-3
references.pmid: 7131463
references.citation: JAMA. 2003 Sep 24;290(12):1600-7
references.pmid: 14506119
references.citation: Int J Cardiol. 1997 Aug 29;61(1):55-9
references.pmid: 9292333
references.citation: Eur Neurol. 1987;26(4):235-40
references.pmid: 3595663
references.citation: Lancet. 1990 May 5;335(8697):1078-80
references.pmid: 1970380
references.citation: Nippon Ganka Gakkai Zasshi. 1975 Dec 10;79(12):1835-9
references.pmid: 1241228
references.citation: JAMA. 2000 Sep 20;284(11):1392-8
references.pmid: 10989401
references.citation: J Rheumatol. 1992 Mar;19(3):402-10
references.pmid: 1578454
references.citation: Am J Cardiol. 2004 Jul 1;94(1):64-8
references.pmid: 15219511
references.citation: Semin Arthritis Rheum. 1998 Feb;27(4):197-217
references.pmid: 9514126
references.citation: J Investig Med. 2004 Sep;52(6):394-401
references.pmid: 15612453
references.citation: Eur Heart J. 1986 Nov;7(11):999-1002
references.pmid: 3792359
references.citation: J Auton Nerv Syst. 1999 Sep 24;77(2-3):190-4
references.pmid: 11130963
references.citation: N Engl J Med. 2005 May 12;352(19):1951-8
references.pmid: 15888695
references.citation: Arch Neurol. 1996 Jul;53(7):691-4
references.pmid: 8929179
references.citation: Anadolu Kardiyol Derg. 2003 Sep;3(3):261-5
references.pmid: 12967895
references.citation: J Neuroophthalmol. 1998 Sep;18(3):182-6
references.pmid: 9736202
references.citation: Am Heart J. 2003 Sep;146(3):404-10
references.pmid: 12947356
references.citation: J Am Coll Cardiol. 1995 Mar 1;25(3):746-52
references.pmid: 7860924
references.citation: Rheumatol Int. 2002 Aug;22(4):155-9
references.pmid: 12172955
references.citation: Kokyu To Junkan. 1991 Sep;39(9):935-8
references.pmid: 1749873
references.citation: J Rheumatol. 1995 Nov;22(11):2103-13
references.pmid: 8596152
references.citation: Am Heart J. 1982 Mar;103(3):438-40
references.pmid: 7064781
references.citation: Arch Mal Coeur Vaiss. 1993 Sep;86(9):1383-5
references.pmid: 8129557
references.citation: J Am Geriatr Soc. 2003 Jan;51(1):63-8
references.pmid: 12534847
references.citation: Heart. 1999 Mar;81(3):297-302
references.pmid: 10026356
references.citation: J Am Coll Cardiol. 2003 Sep 3;42(5):831-8
references.pmid: 12957428
references.citation: J Am Coll Cardiol. 2003 Sep 3;42(5):839-41
references.pmid: 12957429
references.citation: Ann Intern Med. 1985 Jun;102(6):791-3
references.pmid: 3994192
references.citation: Int J Cardiol. 1998 Dec 1;67(2):171-5
references.pmid: 9891952
references.citation: Int J Cardiol. 2007 Apr 4;116(3):285-99
references.pmid: 16837082
references.citation: Circulation. 1992 Jan;85(1 Suppl):I77-91
references.pmid: 1728509
references.citation: Mayo Clin Proc. 2002 Jan;77(1):45-54
references.pmid: 11794458