Abnormal heart rate recovery and deficient chronotropic response after submaximal exercise in young Marfan syndrome patients

Abnormal heart rate recovery and deficient chronotropic response after submaximal exercise in young Marfan syndrome patients

Author Peres, Paulo Alberto Tayar Autor UNIFESP Google Scholar
Carvalho, Antonio Carlos Autor UNIFESP Google Scholar
Perez, Ana Beatriz Alvarez Autor UNIFESP Google Scholar
Medeiros, Wladimir Musetti Autor UNIFESP Google Scholar
Abstract Background: 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. Methods: A total of 12 patients on beta-blocker therapy and 13 off beta-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. Results: 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). Conclusion: 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.
Keywords Marfan syndrome
heart rate
physical exercise
autonomic function
mortality
xmlui.dri2xhtml.METS-1.0.item-coverage Cambridge
Language English
Sponsor Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
Grant number CNPq: 466/06/12
Date 2016
Published in Cardiology In The Young. Cambridge, v. 26, n. 7, p. 1274-1281, 2016.
ISSN 1047-9511 (Sherpa/Romeo, impact factor)
Publisher Cambridge Univ Press
Extent 1274-1281
Origin http://dx.doi.org/10.1017/S1047951115002322
Access rights Closed access
Type Article
Web of Science ID WOS:000384438400005
URI https://repositorio.unifesp.br/handle/11600/57017

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