The relevance of performing exercise test before starting supervised physical exercise in asymptomatic cardiovascular patients with rheumatic diseases

To evaluate the impact and risk factors associated with an abnormal exercise test (ET) in systemic inflammatory rheumatic disease (SIRD) patients before commencing supervised physical exercise. A total of 235 SIRD patients were enrolled in three controlled clinical trials, including 103 RA, 42 SLE a...

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Veröffentlicht in:Rheumatology (Oxford, England) England), 2016-11, Vol.55 (11), p.1978-1986
Hauptverfasser: Klemz, Bárbara Nascimento de Carvalho, Reis-Neto, Edgard Torres Dos, Jennings, Fábio, Siqueira, Usmary Sardinha, Klemz, Fábio Kadratz, Pinheiro, Helder Henrique Costa, Sato, Emília Inoue, Natour, Jamil, Szejnfeld, Vera Lúcia, Pinheiro, Marcelo de Medeiros
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container_end_page 1986
container_issue 11
container_start_page 1978
container_title Rheumatology (Oxford, England)
container_volume 55
creator Klemz, Bárbara Nascimento de Carvalho
Reis-Neto, Edgard Torres Dos
Jennings, Fábio
Siqueira, Usmary Sardinha
Klemz, Fábio Kadratz
Pinheiro, Helder Henrique Costa
Sato, Emília Inoue
Natour, Jamil
Szejnfeld, Vera Lúcia
Pinheiro, Marcelo de Medeiros
description To evaluate the impact and risk factors associated with an abnormal exercise test (ET) in systemic inflammatory rheumatic disease (SIRD) patients before commencing supervised physical exercise. A total of 235 SIRD patients were enrolled in three controlled clinical trials, including 103 RA, 42 SLE and 57 AS patients. The control group consisted of 231 healthy, sedentary subjects matched for age, gender and BMI. All performed an ET, according to Bruce's or Ellestad's protocol. Cardiovascular disease risk factors, medications, comorbidities and details of each SIRD were assessed. SIRD patients had a higher percentage of abnormal ETs compared with the control group, especially exercise hypertensive behaviour, higher oxygen consumption, higher resting heart rate and heart rate at the first minute of recovery, and chronotropic incompetence (C-Inc) (P 
doi_str_mv 10.1093/rheumatology/kew277
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A total of 235 SIRD patients were enrolled in three controlled clinical trials, including 103 RA, 42 SLE and 57 AS patients. The control group consisted of 231 healthy, sedentary subjects matched for age, gender and BMI. All performed an ET, according to Bruce's or Ellestad's protocol. Cardiovascular disease risk factors, medications, comorbidities and details of each SIRD were assessed. SIRD patients had a higher percentage of abnormal ETs compared with the control group, especially exercise hypertensive behaviour, higher oxygen consumption, higher resting heart rate and heart rate at the first minute of recovery, and chronotropic incompetence (C-Inc) (P &lt; 0.001). The disease itself was involved with higher likelihood of having an abnormal ET [Odds ratio (OR) = 12.0, 95% CI: 2.5, 56.7; P = 0.002 for SLE; OR = 13.56, 95% CI: 6.16, 29.8; P &lt; 0.001 for RA; and OR = 4.31, 95% CI: 1.17, 15.8; P = 0.028, for AS]. Each 10-year increment of age increased the chance of having an abnormal ET by 13% (P = 0.008) in AS patients, as well as hypertension (OR = 7.14, 95% CI: 1.61, 31.6; P = 0.01). Regarding C-Inc, age played a protective role (OR = 0.88, 95% CI: 0.78, 0.99; P = 0.043) in SLE, and ASDAS-ESR was associated with a higher risk in AS (OR = 2.73, 95% CI: 0.93, 8.0; P = 0.067). Our results showed a higher prevalence of abnormal ETs in asymptomatic cardiovascular SIRD patients, and the disease itself was associated with a higher likelihood of having an abnormal test, emphasizing the relevance and need of performing it before starting supervised physical exercise.</description><identifier>ISSN: 1462-0324</identifier><identifier>EISSN: 1462-0332</identifier><identifier>DOI: 10.1093/rheumatology/kew277</identifier><identifier>PMID: 27481271</identifier><language>eng</language><publisher>England</publisher><subject>Adult ; Cardiovascular Diseases - diagnosis ; Cardiovascular Diseases - physiopathology ; Cross-Sectional Studies ; Exercise Test ; Exercise Therapy - methods ; Female ; Humans ; Male ; Middle Aged ; Rheumatic Diseases - complications ; Rheumatic Diseases - physiopathology ; Risk Factors</subject><ispartof>Rheumatology (Oxford, England), 2016-11, Vol.55 (11), p.1978-1986</ispartof><rights>The Author 2016. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. 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Each 10-year increment of age increased the chance of having an abnormal ET by 13% (P = 0.008) in AS patients, as well as hypertension (OR = 7.14, 95% CI: 1.61, 31.6; P = 0.01). Regarding C-Inc, age played a protective role (OR = 0.88, 95% CI: 0.78, 0.99; P = 0.043) in SLE, and ASDAS-ESR was associated with a higher risk in AS (OR = 2.73, 95% CI: 0.93, 8.0; P = 0.067). 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A total of 235 SIRD patients were enrolled in three controlled clinical trials, including 103 RA, 42 SLE and 57 AS patients. The control group consisted of 231 healthy, sedentary subjects matched for age, gender and BMI. All performed an ET, according to Bruce's or Ellestad's protocol. Cardiovascular disease risk factors, medications, comorbidities and details of each SIRD were assessed. SIRD patients had a higher percentage of abnormal ETs compared with the control group, especially exercise hypertensive behaviour, higher oxygen consumption, higher resting heart rate and heart rate at the first minute of recovery, and chronotropic incompetence (C-Inc) (P &lt; 0.001). The disease itself was involved with higher likelihood of having an abnormal ET [Odds ratio (OR) = 12.0, 95% CI: 2.5, 56.7; P = 0.002 for SLE; OR = 13.56, 95% CI: 6.16, 29.8; P &lt; 0.001 for RA; and OR = 4.31, 95% CI: 1.17, 15.8; P = 0.028, for AS]. Each 10-year increment of age increased the chance of having an abnormal ET by 13% (P = 0.008) in AS patients, as well as hypertension (OR = 7.14, 95% CI: 1.61, 31.6; P = 0.01). Regarding C-Inc, age played a protective role (OR = 0.88, 95% CI: 0.78, 0.99; P = 0.043) in SLE, and ASDAS-ESR was associated with a higher risk in AS (OR = 2.73, 95% CI: 0.93, 8.0; P = 0.067). Our results showed a higher prevalence of abnormal ETs in asymptomatic cardiovascular SIRD patients, and the disease itself was associated with a higher likelihood of having an abnormal test, emphasizing the relevance and need of performing it before starting supervised physical exercise.</abstract><cop>England</cop><pmid>27481271</pmid><doi>10.1093/rheumatology/kew277</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record>
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subjects Adult
Cardiovascular Diseases - diagnosis
Cardiovascular Diseases - physiopathology
Cross-Sectional Studies
Exercise Test
Exercise Therapy - methods
Female
Humans
Male
Middle Aged
Rheumatic Diseases - complications
Rheumatic Diseases - physiopathology
Risk Factors
title The relevance of performing exercise test before starting supervised physical exercise in asymptomatic cardiovascular patients with rheumatic diseases
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