Rheumatology Division, School of Medicine, University of São Paulo, SP, Brazil.
Lupus. 2013 Aug;22(9):928-31. doi: 10.1177/0961203313497415.
Primary antiphospholipid syndrome (PAPS) is associated with increased risk of cardiovascular disease and mortality. Aerobic capacity and cardiac autonomic control are also associated with these risks. The aim of our study was to assess aerobic capacity and cardiac autonomic control in PAPS patients. Thirteen women with PAPS and 13 healthy controls matched for age, gender, and body mass index were enrolled for the study. Both groups were sedentary and were not under chronotropic, antidepressants and hypolipemiant drugs. All subjects performed a treadmill-graded maximal exercise. Aerobic capacity was assessed by peak oxygen uptake (VO2peak), time at anaerobic ventilatory threshold (VAT) and respiratory compensation point (RCP) and time-to-exhaustion, whereas cardiac autonomic control was assessed by chronotropic reserve (CR) and heart rate recovery at the first and second minutes after graded exercise (HRR1min and HRR2min, respectively). All aerobic capacity indexes were reduced more in PAPS patients than in healthy subjects: VO2peak (30.2 ± 4.7 vs 34.6 ± 4.3 ml.kg(-1).min(-1), p = 0.021), time at VAT (3.0 ± 1.5 vs 5.0 ± 2.0 min, p = 0.016), time at RCP (6.5 ± 2.0 vs 8.0 ± 2.0 min, p = 0.050), time-to-exhaustion (8.5 ± 2.0 vs 11.0 ± 2.5 min, p = 0.010). HRR1min (22 ± 9 vs 30 ± 7 bpm, p = 0.032) and HRR2min (33 ± 9 vs 46 ± 8 bpm, p = 0.002) were delayed in PAPS patients compared to healthy controls but CR was not significantly different (p = 0.272). In conclusion, an impaired aerobic capacity and cardiac autonomic control was identified in PAPS.
原发性抗磷脂综合征（PAPS）与心血管疾病和死亡率风险增加相关。有氧能力和心脏自主神经控制也与这些风险相关。我们的研究目的是评估 PAPS 患者的有氧能力和心脏自主神经控制。纳入了 13 名患有 PAPS 的女性患者和 13 名年龄、性别和体重指数相匹配的健康对照者进行研究。两组均为久坐人群，未服用变时性、抗抑郁药和降脂药。所有受试者均进行了跑步机分级最大运动试验。通过峰值摄氧量（VO2peak）、无氧通气阈值（VAT）和呼吸补偿点（RCP）时的时间以及运动至力竭的时间来评估有氧能力，通过变时性储备（CR）和分级运动后第 1 和第 2 分钟的心率恢复（HRR1min 和 HRR2min）来评估心脏自主神经控制。与健康对照组相比，PAPS 患者的所有有氧能力指标均显著降低：VO2peak（30.2±4.7 比 34.6±4.3ml·kg-1·min-1，p=0.021）、VAT 时的时间（3.0±1.5 比 5.0±2.0min，p=0.016）、RCP 时的时间（6.5±2.0 比 8.0±2.0min，p=0.050）、运动至力竭的时间（8.5±2.0 比 11.0±2.5min，p=0.010）。与健康对照组相比，PAPS 患者的 HRR1min（22±9 比 30±7bpm，p=0.032）和 HRR2min（33±9 比 46±8bpm，p=0.002）延迟，但 CR 无显著差异（p=0.272）。总之，在 PAPS 中发现了受损的有氧能力和心脏自主神经控制。
