Abnormal heart rate recovery and deficient chronotropic response after submaximal exercise in young Marfan syndrome patients
Marfan syndrome patients present important cardiac structural changes, ventricular dysfunction, and electrocardiographic changes. An abnormal heart rate response during or after exercise is an independent predictor of mortality and autonomic dysfunction. The aim of the present study was to compare h...
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| Veröffentlicht in: | Cardiology in the young 2016-10, Vol.26 (7), p.1274-1281 |
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| creator | Peres, Paulo Carvalho, Antônio C. Perez, Ana Beatriz A. Medeiros, Wladimir M. |
| description | Marfan syndrome patients present important cardiac structural changes, ventricular dysfunction, and electrocardiographic changes. An abnormal heart rate response during or after exercise is an independent predictor of mortality and autonomic dysfunction. The aim of the present study was to compare heart rate recovery and chronotropic response obtained by cardiac reserve in patients with Marfan syndrome subjected to submaximal exercise.
A total of 12 patients on β-blocker therapy and 13 off β-blocker therapy were compared with 12 healthy controls. They were subjected to submaximal exercise with lactate measurements. The heart rate recovery was obtained in the first minute of recovery and corrected for cardiac reserve and peak lactate concentration.
Peak heart rate (141±16 versus 155±17 versus 174±8 bpm; p=0.001), heart rate reserve (58.7±9.4 versus 67.6±14.3 versus 82.6±4.8 bpm; p=0.001), heart rate recovery (22±6 versus 22±8 versus 34±9 bpm; p=0.001), and heart rate recovery/lactate (3±1 versus 3±1 versus 5±1 bpm/mmol/L; p=0.003) were different between Marfan groups and controls, respectively. All the patients with Marfan syndrome had heart rate recovery values below the mean observed in the control group. The absolute values of heart rate recovery were strongly correlated with the heart rate reserve (r=0.76; p=0.001).
Marfan syndrome patients have reduced heart rate recovery and chronotropic deficit after submaximal exercise, and the chronotropic deficit is a strong determinant of heart rate recovery. These changes are suggestive of autonomic dysfunction. |
| doi_str_mv | 10.1017/S1047951115002322 |
| format | Article |
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A total of 12 patients on β-blocker therapy and 13 off β-blocker therapy were compared with 12 healthy controls. They were subjected to submaximal exercise with lactate measurements. The heart rate recovery was obtained in the first minute of recovery and corrected for cardiac reserve and peak lactate concentration.
Peak heart rate (141±16 versus 155±17 versus 174±8 bpm; p=0.001), heart rate reserve (58.7±9.4 versus 67.6±14.3 versus 82.6±4.8 bpm; p=0.001), heart rate recovery (22±6 versus 22±8 versus 34±9 bpm; p=0.001), and heart rate recovery/lactate (3±1 versus 3±1 versus 5±1 bpm/mmol/L; p=0.003) were different between Marfan groups and controls, respectively. All the patients with Marfan syndrome had heart rate recovery values below the mean observed in the control group. The absolute values of heart rate recovery were strongly correlated with the heart rate reserve (r=0.76; p=0.001).
Marfan syndrome patients have reduced heart rate recovery and chronotropic deficit after submaximal exercise, and the chronotropic deficit is a strong determinant of heart rate recovery. These changes are suggestive of autonomic dysfunction.</description><identifier>ISSN: 1047-9511</identifier><identifier>EISSN: 1467-1107</identifier><identifier>DOI: 10.1017/S1047951115002322</identifier><identifier>PMID: 26521836</identifier><language>eng</language><publisher>Cambridge, UK: Cambridge University Press</publisher><subject>Adolescent ; Adrenergic beta-Antagonists - therapeutic use ; Adult ; Autonomic Nervous System - physiopathology ; Brazil ; Case-Control Studies ; Child ; Exercise ; Exercise Test ; Exercise Tolerance ; Female ; Heart Rate ; Humans ; Male ; Marfan Syndrome - drug therapy ; Marfan Syndrome - physiopathology ; Original Articles ; Young Adult</subject><ispartof>Cardiology in the young, 2016-10, Vol.26 (7), p.1274-1281</ispartof><rights>Cambridge University Press 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c406t-e79d843588965653d3379e1a3e430c84246a767cb8a2b7dcd1bc1e77c1bd1e2d3</citedby><cites>FETCH-LOGICAL-c406t-e79d843588965653d3379e1a3e430c84246a767cb8a2b7dcd1bc1e77c1bd1e2d3</cites><orcidid>0000-0001-7453-6738 ; 0000-0002-7199-6170</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.cambridge.org/core/product/identifier/S1047951115002322/type/journal_article$$EHTML$$P50$$Gcambridge$$H</linktohtml><link.rule.ids>164,314,780,784,27924,27925,55628</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26521836$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Peres, Paulo</creatorcontrib><creatorcontrib>Carvalho, Antônio C.</creatorcontrib><creatorcontrib>Perez, Ana Beatriz A.</creatorcontrib><creatorcontrib>Medeiros, Wladimir M.</creatorcontrib><title>Abnormal heart rate recovery and deficient chronotropic response after submaximal exercise in young Marfan syndrome patients</title><title>Cardiology in the young</title><addtitle>Cardiol Young</addtitle><description>Marfan syndrome patients present important cardiac structural changes, ventricular dysfunction, and electrocardiographic changes. An abnormal heart rate response during or after exercise is an independent predictor of mortality and autonomic dysfunction. The aim of the present study was to compare heart rate recovery and chronotropic response obtained by cardiac reserve in patients with Marfan syndrome subjected to submaximal exercise.
A total of 12 patients on β-blocker therapy and 13 off β-blocker therapy were compared with 12 healthy controls. They were subjected to submaximal exercise with lactate measurements. The heart rate recovery was obtained in the first minute of recovery and corrected for cardiac reserve and peak lactate concentration.
Peak heart rate (141±16 versus 155±17 versus 174±8 bpm; p=0.001), heart rate reserve (58.7±9.4 versus 67.6±14.3 versus 82.6±4.8 bpm; p=0.001), heart rate recovery (22±6 versus 22±8 versus 34±9 bpm; p=0.001), and heart rate recovery/lactate (3±1 versus 3±1 versus 5±1 bpm/mmol/L; p=0.003) were different between Marfan groups and controls, respectively. All the patients with Marfan syndrome had heart rate recovery values below the mean observed in the control group. The absolute values of heart rate recovery were strongly correlated with the heart rate reserve (r=0.76; p=0.001).
Marfan syndrome patients have reduced heart rate recovery and chronotropic deficit after submaximal exercise, and the chronotropic deficit is a strong determinant of heart rate recovery. These changes are suggestive of autonomic dysfunction.</description><subject>Adolescent</subject><subject>Adrenergic beta-Antagonists - therapeutic use</subject><subject>Adult</subject><subject>Autonomic Nervous System - physiopathology</subject><subject>Brazil</subject><subject>Case-Control Studies</subject><subject>Child</subject><subject>Exercise</subject><subject>Exercise Test</subject><subject>Exercise Tolerance</subject><subject>Female</subject><subject>Heart Rate</subject><subject>Humans</subject><subject>Male</subject><subject>Marfan Syndrome - drug therapy</subject><subject>Marfan Syndrome - physiopathology</subject><subject>Original Articles</subject><subject>Young Adult</subject><issn>1047-9511</issn><issn>1467-1107</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkU2L1TAUhoMozof-ADcScOOmTk7SJulyGPwYGJmFui5pcjrT4TapJ63MBX-8KXMVUQRXCbzPeULOy9gLEG9AgDn7BKI2bQMAjRBSSfmIHUOtTQUgzONyL3G15UfsJOc7IUApEE_ZkdSNBKv0Mft-3sdEk9vxW3S0cHILckKfviHtuYuBBxxGP2JcuL-lFNNCaR59YfKcYkbuhgWJ57Wf3P24ifAeyY8lGSPfpzXe8I-OBhd53sdAaUI-u2UT5mfsyeB2GZ8fzlP25d3bzxcfqqvr95cX51eVr4VeKjRtsLVqrG11oxsVlDItglNYK-FtLWvtjDa-t072JvgAvQc0xkMfAGVQp-z1g3em9HXFvHTTmD3udi5iWnMHVpoWbK3V_6BQWKl0QV_9gd6llWL5yEaJRltpbaHggfKUciYcupnKmmjfgei2Fru_WiwzLw_mslUMvyZ-1lYAdZC6qacx3OBvb_9T-wPB86eN</recordid><startdate>201610</startdate><enddate>201610</enddate><creator>Peres, Paulo</creator><creator>Carvalho, Antônio C.</creator><creator>Perez, Ana Beatriz A.</creator><creator>Medeiros, Wladimir M.</creator><general>Cambridge University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>7QO</scope><orcidid>https://orcid.org/0000-0001-7453-6738</orcidid><orcidid>https://orcid.org/0000-0002-7199-6170</orcidid></search><sort><creationdate>201610</creationdate><title>Abnormal heart rate recovery and deficient chronotropic response after submaximal exercise in young Marfan syndrome patients</title><author>Peres, Paulo ; Carvalho, Antônio C. ; Perez, Ana Beatriz A. ; Medeiros, Wladimir M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c406t-e79d843588965653d3379e1a3e430c84246a767cb8a2b7dcd1bc1e77c1bd1e2d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adolescent</topic><topic>Adrenergic beta-Antagonists - therapeutic use</topic><topic>Adult</topic><topic>Autonomic Nervous System - physiopathology</topic><topic>Brazil</topic><topic>Case-Control Studies</topic><topic>Child</topic><topic>Exercise</topic><topic>Exercise Test</topic><topic>Exercise Tolerance</topic><topic>Female</topic><topic>Heart Rate</topic><topic>Humans</topic><topic>Male</topic><topic>Marfan Syndrome - drug therapy</topic><topic>Marfan Syndrome - physiopathology</topic><topic>Original Articles</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Peres, Paulo</creatorcontrib><creatorcontrib>Carvalho, Antônio C.</creatorcontrib><creatorcontrib>Perez, Ana Beatriz A.</creatorcontrib><creatorcontrib>Medeiros, Wladimir M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>Biotechnology Research Abstracts</collection><jtitle>Cardiology in the young</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Peres, Paulo</au><au>Carvalho, Antônio C.</au><au>Perez, Ana Beatriz A.</au><au>Medeiros, Wladimir M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Abnormal heart rate recovery and deficient chronotropic response after submaximal exercise in young Marfan syndrome patients</atitle><jtitle>Cardiology in the young</jtitle><addtitle>Cardiol Young</addtitle><date>2016-10</date><risdate>2016</risdate><volume>26</volume><issue>7</issue><spage>1274</spage><epage>1281</epage><pages>1274-1281</pages><issn>1047-9511</issn><eissn>1467-1107</eissn><abstract>Marfan syndrome patients present important cardiac structural changes, ventricular dysfunction, and electrocardiographic changes. An abnormal heart rate response during or after exercise is an independent predictor of mortality and autonomic dysfunction. The aim of the present study was to compare heart rate recovery and chronotropic response obtained by cardiac reserve in patients with Marfan syndrome subjected to submaximal exercise.
A total of 12 patients on β-blocker therapy and 13 off β-blocker therapy were compared with 12 healthy controls. They were subjected to submaximal exercise with lactate measurements. The heart rate recovery was obtained in the first minute of recovery and corrected for cardiac reserve and peak lactate concentration.
Peak heart rate (141±16 versus 155±17 versus 174±8 bpm; p=0.001), heart rate reserve (58.7±9.4 versus 67.6±14.3 versus 82.6±4.8 bpm; p=0.001), heart rate recovery (22±6 versus 22±8 versus 34±9 bpm; p=0.001), and heart rate recovery/lactate (3±1 versus 3±1 versus 5±1 bpm/mmol/L; p=0.003) were different between Marfan groups and controls, respectively. All the patients with Marfan syndrome had heart rate recovery values below the mean observed in the control group. The absolute values of heart rate recovery were strongly correlated with the heart rate reserve (r=0.76; p=0.001).
Marfan syndrome patients have reduced heart rate recovery and chronotropic deficit after submaximal exercise, and the chronotropic deficit is a strong determinant of heart rate recovery. These changes are suggestive of autonomic dysfunction.</abstract><cop>Cambridge, UK</cop><pub>Cambridge University Press</pub><pmid>26521836</pmid><doi>10.1017/S1047951115002322</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-7453-6738</orcidid><orcidid>https://orcid.org/0000-0002-7199-6170</orcidid></addata></record> |
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| subjects | Adolescent Adrenergic beta-Antagonists - therapeutic use Adult Autonomic Nervous System - physiopathology Brazil Case-Control Studies Child Exercise Exercise Test Exercise Tolerance Female Heart Rate Humans Male Marfan Syndrome - drug therapy Marfan Syndrome - physiopathology Original Articles Young Adult |
| title | Abnormal heart rate recovery and deficient chronotropic response after submaximal exercise in young Marfan syndrome patients |
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