Department of Cardiology, Erciyes University School of Medicine Kayseri, 38039 Kayseri, Turkey.
Rheumatol Int. 2011 Jan;31(1):121-5. doi: 10.1007/s00296-010-1550-y. Epub 2010 Jul 22.
Heart rate recovery after exercise is a function of vagal reactivation, and its impairment is an independent prognostic indicator for cardiovascular and all-cause mortality. The aim of our study was to evaluate heart rate recovery in patients with familial Mediterranean fever (FMF). The study population included 38 patients with FMF (14 men; mean age, 36.2 ± 12.1 years, and mean disease duration = 11.3 ± 6.5 years) and 35 healthy control subjects (12 men; mean age = 34.1 ± 9.9 years). Basal electrocardiography, echocardiography, and treadmill exercise testing were performed in all patients and control participants. The heart rate recovery index was defined as the reduction in the heart rate from the rate at peak exercise to the rate 1st-minute (HRR(1)), 2nd-minute (HRR(2)), 3rd-minute (HRR(3)), and 5th-minute (HRR(5)) after the cessation of exercise stress testing. There are significant differences in HRR(1) and HRR(2) indices between patients with FMF and control group (26.4 ± 7.4 vs. 35.0 ± 8.0; P = 0.001 and 47.3 ± 11.8 vs. 54.8 ± 10.3; P = 0.002, respectively). Similarly, HRR(3) and HRR(5) indices of the recovery period were lower in patients with FMF, when compared with indices in the control group (56.0 ± 14.0 vs. 63.7 ± 11.2; P = 0.01 and 64.1 ± 14.7 vs. 71.5 ± 12.7; P = 0.02, respectively). There were also remarkably positive correlations between the disease duration and HRR(1) (r = 0.31, P = 0.02), and HRR(2) (r = 0.26, P = 0.04). The heart rate recovery index impaired in patients with FMF compared to control subjects. When the prognostic significance of the heart rate recovery index is considered, a useful, simple, and noninvasive test may be clinically helpful in the recognition of high-risk patients with FMF.
运动后心率恢复是迷走神经再激活的功能，其受损是心血管和全因死亡率的独立预后指标。我们的研究目的是评估家族性地中海热（FMF）患者的心率恢复情况。研究人群包括 38 名 FMF 患者（男性 14 名；平均年龄 36.2 ± 12.1 岁，平均病程 = 11.3 ± 6.5 年）和 35 名健康对照者（男性 12 名；平均年龄 34.1 ± 9.9 岁）。所有患者和对照者均行基础心电图、超声心动图和跑步机运动试验。心率恢复指数定义为运动应激试验停止后第 1 分钟（HRR(1)）、第 2 分钟（HRR(2)）、第 3 分钟（HRR(3)）和第 5 分钟（HRR(5)）时心率从峰值运动时的降低率。FMF 患者的 HRR(1)和 HRR(2)指数与对照组之间存在显著差异（26.4 ± 7.4 与 35.0 ± 8.0；P = 0.001 和 47.3 ± 11.8 与 54.8 ± 10.3；P = 0.002）。同样，与对照组相比，FMF 患者恢复期的 HRR(3)和 HRR(5)指数较低（56.0 ± 14.0 与 63.7 ± 11.2；P = 0.01 和 64.1 ± 14.7 与 71.5 ± 12.7；P = 0.02）。疾病持续时间与 HRR(1)（r = 0.31，P = 0.02）和 HRR(2)（r = 0.26，P = 0.04）之间也存在显著正相关。与对照组相比，FMF 患者的心率恢复指数受损。考虑到心率恢复指数的预后意义，一种有用的、简单的、非侵入性的测试可能有助于临床上识别 FMF 高危患者。
