Kaya Ergun Baris, Yorgun Hikmet, Akdogan Ali, Ates Ahmet Hakan, Canpolat Ugur, Sunman Hamza, Aytemir Kudret, Tokgozoglu Lale, Kabakci Giray, Calguneri Meral, Ozkutlu Hilmi, Oto Ali
Department of Cardiology, Hacettepe University Faculty of Medicine, Altindag 06100, Ankara, Turkey.
Tex Heart Inst J. 2009;36(4):282-6.
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.
白塞病是一种多系统炎症性疾病，与多种心血管功能障碍有关，包括室性心律失常和心源性猝死。运动后的心率恢复情况既可以评估副交感神经张力受损程度，也可以作为全因死亡和心血管死亡的预后指标。我们研究的目的是评估白塞病患者的心率恢复情况。2008年1月至7月，我们在门诊对30例连续的白塞病患者和50名年龄及性别匹配的健康对照者进行了检查，并进行了前瞻性研究。所有患者和对照者均进行了基础心电图、超声心动图和跑步机运动试验。心率恢复指数采用常规方法计算，即从运动应激试验后的最大心率中减去第1分钟（Rec1）、第2分钟（Rec2）和第3分钟（Rec3）的恢复心率。与健康对照者相比，白塞病患者的心率恢复数值明显较低：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；Rec3，56.2±12.11 vs 67.4±8.7，P = 0.014。据我们所知，这是第一项显示白塞病患者心率恢复指数受损（提示副交感神经活动减弱）的研究。鉴于心率恢复指数具有独立的预后价值，我们的研究结果可能解释了白塞病患者心律失常和心源性猝死发生率增加的原因。因此，该指数在识别高危患者方面可能具有临床应用价值。
