Attenuated post-exercise heart rate recovery in patients with systemic lupus erythematosus: the role of disease severity and beta-blocker treatment

Objective Sinus tachycardia is frequently reported in systemic lupus erythematosus (SLE), while there are limited data on post-exercise ability to slow heart rate (i.e. heart rate recovery, HRR) in this group of patients. Methods We studied consecutive 70 patients with SLE and 30 healthy controls. A...

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Bibliographic Details
Published in:Lupus 2018-02, Vol.27 (2), p.217-224
Main Authors: Bienias, P, Ciurzyński, M, Chrzanowska, A, Dudzik-Niewiadomska, I, Irzyk, K, Oleszek, K, Kalińska-Bienias, A, Kisiel, B, Tłustochowicz, W, Pruszczyk, P
Format: Article
Language:English
Subjects:
Adrenergic beta-Antagonists - adverse effects
Adult
Autonomic nervous system
Autonomic Nervous System - physiopathology
Beta blockers
Coronary artery
Diabetes mellitus
Echocardiography
Echocardiography - methods
Electrocardiography, Ambulatory - methods
Exercise Test - methods
Exercise Tolerance - physiology
Female
Heart - diagnostic imaging
Heart - physiopathology
Heart diseases
Heart rate
Heart Rate - drug effects
Heart Rate - physiology
Humans
Hypertension
Hypertension - drug therapy
Hypertension - physiopathology
Lupus
Lupus Erythematosus, Systemic - physiopathology
Male
Middle Aged
Patients
Physical training
Prospective Studies
Severity of Illness Index
Sinus
Stroke Volume - physiology
Systemic lupus erythematosus
Tachycardia
Tachycardia, Sinus - drug therapy
Tachycardia, Sinus - physiopathology
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Summary:Objective Sinus tachycardia is frequently reported in systemic lupus erythematosus (SLE), while there are limited data on post-exercise ability to slow heart rate (i.e. heart rate recovery, HRR) in this group of patients. Methods We studied consecutive 70 patients with SLE and 30 healthy controls. All examined individuals underwent detailed clinical examination, echocardiography, Holter monitoring with heart rate variability and treadmill stress test using Bruce’s protocol. HRR values were calculated as the difference between maximum HR during exercise and HR at the first (HRR1) and third (HRR3) minute of rest. Individuals with coronary artery disease, diabetes mellitus and suspected pulmonary hypertension were excluded from further analysis (n = 15). Results Fifty-five SLE patients were eligible for this study: aged 41.5 ± 12.4 years, 87.3% women, SLICC/ACR-DI score 3.58 ± 1.85. In the SLE group 36.4% patients received beta-blockers, usually for previously detected sinus tachycardia and/or arterial hypertension. Mean HRR1 (36.9 ± 12.6 vs 49.5 ± 18.6, p = 0.0004) and HRR3 (55.5 ± 14.3 vs 69.2 ± 16.4, p = 0.0001) were significantly lower in SLE than in healthy individuals. Significantly negative correlations between SLICC/ACR-DI score and HRR1 (r = –0.299, p = 0.01), HRR3 (r = –0.361, p = 0.001) and exercise capacity (r = –0.422, p 
ISSN:0961-2033
1477-0962
DOI:10.1177/0961203317716318