Abnormal heart rate recovery on exercise in ankylosing spondylitis.
OBJECTIVE
This study evaluated the heart rate recovery response in ankylosing spondylitis (AS) patients and control subjects.


BACKGROUND
Delayed heart rate recovery after exercise reflects AD and independently predicts adverse cardiac outcome.


METHODS
Fifty-one patients with AS and 50 age- and matched controls received electrocardiography, echocardiography, and treadmill exercise testing. The heart rate recovery (HRR) index was calculated as the reduction in heart rate from the rate at peak exercise to the rate at the 1st (HRR1), 2nd (HRR2), 3rd (HRR3) and 5th (HRR5) minute after the cessation of exercise stress testing.


RESULTS
There were significant differences in HRR1 and HRR2 indices between patients and controls (24.8 ± 12.1 vs 34.9 ± 11.0; p<0.001 and 41.2 ± 14.2 vs 54.3 ± 11.8; p<0.001, beats/min, respectively). Similarly, HRR3 and HRR5 indices were lower in patients than controls (51.3 ± 15.1 vs 65.2 ± 14.0; p<0.001 and 61.0 ± 14.2 vs 76.1 ± 14.8; p<0.001). In addition, exercise capacity was markedly lower (8.1 ± 2.0 vs 10.5 ± 2.5 METs; p<0.001) in AS than controls.


CONCLUSIONS
The HRR index is impaired in AS patients, implying the occurrence of autonomic dysfunction even without active joint disease or frank cardiac involvement.
Department of Cardiology, Erciyes University, Faculty of Medicine, Kayseri, Turkey.
Mehmet G
MG
Kaya
Mahmut
M
Akpek
Yat-Yin
YY
Lam
Orhan
O
Dogdu
Idris
I
Ardic
Ozgur
O
Akgul
Salih
S
Ozgocmen
D000328:Adult; D004562:Electrocardiography / Q000379:methods; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test / Q000379:methods*; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function / Q000502:physiology*; D013167:Spondylitis, Ankylosing / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D014463:Ultrasonography
Ankylosing spondylitis; Autonomic dysfunction; Exercise test; Heart rate recovery index