Erciyes University School of Medicine, Department of Cardiology, Kayseri, Turkey.
J Rheumatol. 2010 Dec;37(12):2511-5. doi: 10.3899/jrheum.100163. Epub 2010 Sep 1.
Systemic lupus erythematosus (SLE) is an autoimmune disorder resulting in multisystemic inflammatory damage. It is reported that cardiovascular diseases (CVD) are responsible for 20%-30% of deaths in patients with SLE. 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 the heart rate recovery index in patients with SLE.
The study population included 48 patients with SLE (35 women, mean age 46.3 ± 12.8 yrs, mean disease duration 6.0 ± 2.3 yrs) and 44 healthy controls (30 women, mean age 45.7 ± 12.9 yrs). Basal electrocardiography, echocardiography, and treadmill exercise testing were performed on all patients and controls. The heart rate recovery index was defined as the reduction in the heart rate from the rate at peak exercise to the rate at the first minute (HRR(1)), second minute (HRR(2)), third minute (HRR(3)), and fifth minute (HRR(5)) after stopping exercise stress testing.
There were significant differences in HRR(1) and HRR(2) indices between patients with SLE and the control group (24.1 ± 6.5 vs 33.3 ± 9.3; p < 0.001, and 44.6 ± 13.3 vs 53.7 ± 9.9; p < 0.001, respectively). Similarly, HRR(3) and HRR(5) indices of the recovery period were lower in patients with SLE, compared with indices in the control group (57.6 ± 13.0 vs 64.9 ± 11.7; p = 0.006, and 67.2 ± 12.3 vs 75.0 ± 15.4; p = 0.009, respectively). Effort capacity was markedly lower (9.0 ± 1.9 vs 11.1 ± 2.3 metabolic equivalents; p = 0.001, respectively) among the patients with SLE.
The heart rate recovery index is deteriorated in patients with SLE. When the prognostic significance of the heart rate recovery index is considered, these results may contribute to explain the increased occurrence of cardiac death. It points to the importance of the heart rate recovery index in the identification of high-risk patients.
系统性红斑狼疮（SLE）是一种自身免疫性疾病，导致多系统炎症损伤。据报道，心血管疾病（CVD）占 SLE 患者死亡的 20%-30%。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 SLE 患者的心率恢复指数。
研究人群包括 48 例 SLE 患者（35 名女性，平均年龄 46.3 ± 12.8 岁，平均病程 6.0 ± 2.3 年）和 44 名健康对照者（30 名女性，平均年龄 45.7 ± 12.9 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试验终止后第 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下降率。
SLE 患者的 HRR(1)和 HRR(2)指数与对照组有显著差异（24.1 ± 6.5 对 33.3 ± 9.3；p < 0.001，和 44.6 ± 13.3 对 53.7 ± 9.9；p < 0.001）。同样，SLE 患者恢复期的 HRR(3)和 HRR(5)指数也低于对照组（57.6 ± 13.0 对 64.9 ± 11.7；p = 0.006，和 67.2 ± 12.3 对 75.0 ± 15.4；p = 0.009）。SLE 患者的运动能力明显较低（9.0 ± 1.9 对 11.1 ± 2.3 代谢当量；p = 0.001）。
SLE 患者的心率恢复指数恶化。当考虑心率恢复指数的预后意义时，这些结果可能有助于解释心脏死亡发生率的增加。这表明心率恢复指数在识别高危患者中的重要性。
