title: Cardiac autonomic impairment and chronotropic incompetence in fibromyalgia.
abstract: BACKGROUND
  We aimed to gather knowledge on the cardiac autonomic modulation in patients with fibromyalgia (FM) in response to exercise and to investigate whether this population suffers from chronotropic incompetence (CI).
  
  
  METHODS
  Fourteen women with FM (age: 46 ± 3 years; body mass index (BMI): 26.6 ± 1.4 kg/m2) and 14 gender-, BMI- (25.4 ± 1.3 kg/m2), and age-matched (age: 41 ± 4 years) healthy individuals (CTRL) took part in this cross-sectional study. A treadmill cardiorespiratory test was performed and heart-rate (HR) response during exercise was evaluated by the chronotropic reserve. HR recovery (deltaHRR) was defined as the difference between HR at peak exercise and at both first (deltaHRR1) and second (deltaHRR2) minutes after the exercise test.
  
  
  RESULTS
  FM patients presented lower maximal oxygen consumption (VO2 max) when compared with healthy subjects (22 ± 1 versus CTRL: 32 ± 2 mL/kg/minute, respectively; P < 0.001). Additionally, FM patients presented lower chronotropic reserve (72.5 ± 5 versus CTRL: 106.1 ± 6, P < 0.001), deltaHRR1 (24.5 ± 3 versus CTRL: 32.6 ± 2, P = 0.059) and deltaHRR2 (34.3 ± 4 versus CTRL: 50.8 ± 3, P = 0.002) than their healthy peers. The prevalence of CI was 57.1% among patients with FM.
  
  
  CONCLUSIONS
  Patients with FM who undertook a graded exercise test may present CI and delayed HR recovery, both being indicative of cardiac autonomic impairment and higher risk of cardiovascular events and mortality.
authors.affiliation: Division of Rheumatology, School of Medicine, University of Sao Paulo, Brazil, Av, Dr, Arnaldo, 455, Cerqueira César, Brazil.
authors.forename: Roberta Potenza
authors.initials: RP
authors.lastname: da Cunha Ribeiro
authors.forename: Hamilton
authors.initials: H
authors.lastname: Roschel
authors.forename: Guilherme Gianini
authors.initials: GG
authors.lastname: Artioli
authors.forename: Thalita
authors.initials: T
authors.lastname: Dassouki
authors.forename: Luiz Augusto
authors.initials: LA
authors.lastname: Perandini
authors.forename: Ana Luisa
authors.initials: AL
authors.lastname: Calich
authors.forename: Ana Lúcia
authors.initials: AL
authors.lastname: de Sá Pinto
authors.forename: Fernanda Rodrigues
authors.initials: FR
authors.lastname: Lima
authors.forename: Eloísa
authors.initials: E
authors.lastname: Bonfá
authors.forename: Bruno
authors.initials: B
authors.lastname: Gualano
mesh_terms: D000328:Adult; D001341:Autonomic Nervous System / Q000503:physiopathology*; D002318:Cardiovascular Diseases / Q000503:physiopathology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005080:Exercise Test; D005260:Female; D005356:Fibromyalgia / Q000503:physiopathology*; D006321:Heart / Q000294:innervation / Q000503:physiopathology*; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology; D018570:Risk Assessment / Q000706:statistics & numerical data; D012307:Risk Factors
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