Rheumatology International

, Volume 31, Issue 1, pp 121–125 | Cite as

Assessment of heart rate recovery index in patients with familial Mediterranean fever

  • Idris Ardic
  • Mehmet Gungor Kaya
  • Mikail Yarlioglues
  • Orhan Dogdu
  • Mehmet Celikbilek
  • Mahmut Akpek
  • Lutfi Akyol
  • Edip Torun
Short Communication

Abstract

Heart rate recovery after exercise is a function of vagal reactivation, and its impairment is an independent prognostic indicator for cardiovascular and all-cause mortality. The aim of our study was to evaluate heart rate recovery in patients with familial Mediterranean fever (FMF). The study population included 38 patients with FMF (14 men; mean age, 36.2 ± 12.1 years, and mean disease duration = 11.3 ± 6.5 years) and 35 healthy control subjects (12 men; mean age = 34.1 ± 9.9 years). Basal electrocardiography, echocardiography, and treadmill exercise testing were performed in all patients and control participants. The heart rate recovery index was defined as the reduction in the heart rate from the rate at peak exercise to the rate 1st-minute (HRR1), 2nd-minute (HRR2), 3rd-minute (HRR3), and 5th-minute (HRR5) after the cessation of exercise stress testing. There are significant differences in HRR1 and HRR2 indices between patients with FMF and control group (26.4 ± 7.4 vs. 35.0 ± 8.0; P = 0.001 and 47.3 ± 11.8 vs. 54.8 ± 10.3; P = 0.002, respectively). Similarly, HRR3 and HRR5 indices of the recovery period were lower in patients with FMF, when compared with indices in the control group (56.0 ± 14.0 vs. 63.7 ± 11.2; P = 0.01 and 64.1 ± 14.7 vs. 71.5 ± 12.7; P = 0.02, respectively). There were also remarkably positive correlations between the disease duration and HRR1 (r = 0.31, P = 0.02), and HRR2 (r = 0.26, P = 0.04). The heart rate recovery index impaired in patients with FMF compared to control subjects. When the prognostic significance of the heart rate recovery index is considered, a useful, simple, and noninvasive test may be clinically helpful in the recognition of high-risk patients with FMF.

Keywords

FMF Heart rate recovery index Exercise test Autonomic nervous system 

Notes

Conflict of interest

None.

References

  1. 1.
    Ben-Chetrit E, Levy M (1998) Familial Mediterranean fever. Lancet 351:659–664CrossRefPubMedGoogle Scholar
  2. 2.
    Yüksel S, Ayvazyan L, Gasparyan AY (2010) Familial Mediterranean fever as an emerging clinical model of atherogenesis associated with low-grade inflammation. Open Cardiovasc Med J 4:51–56PubMedGoogle Scholar
  3. 3.
    Gasparyan AY, Ugurlucan M (2008) The emerging issue of cardiovascular involvement in familial Mediterranean fever. Arch Med Sci 4(4):465–467Google Scholar
  4. 4.
    Cole CR, Blackstone EH, Pashkow FJ, Snader CE, Lauer MS (1999) Heart-rate recovery immediately after exercise as a predictor of mortality. N Engl J Med 341:1351–1357CrossRefPubMedGoogle Scholar
  5. 5.
    Nishime EO, Cole CR, Blackstone EH, Pashkow FJ, Lauer MS (2000) Heart rate recovery and treadmill exercise score as predictors of mortality in patients referred for exercise ECG. JAMA 284(11):1392–1398CrossRefPubMedGoogle Scholar
  6. 6.
    Rozenbaum M, Naschitz JE, Yudashkin M, Rosner I, Sabo E, Shaviv N, Gaitini L, Zuckerman E, Yeshurun D (2002) Cardiovascular autonomic dysfunction in familial Mediterranean fever. J Rheumatol 29:987–989PubMedGoogle Scholar
  7. 7.
    Pras M, Kastner DL (1997) Familial Mediterranean fever. In: Klippel JH, Dieppe PA (eds) Rheumatology, 2nd edn. Mosby, London, pp 23.1–23.4Google Scholar
  8. 8.
    Imai K, Sato H, Hori M, Kusuoka H, Ozaki H, Yokoyama H, Takeda H, Inoue M, Kamada T (1994) Vagally mediated heart rate recovery after exercise is accelerated in athletes but blunted in patients with chronic heart failure. J Am Coll Cardiol 24(6):1529–1535CrossRefPubMedGoogle Scholar
  9. 9.
    Savin WM, Davidson DM, Haskell WL (1982) Autonomic contribution to heart rate recovery from exercise in human. J Applied Physiology 53:1572–1575Google Scholar
  10. 10.
    Jouven X, Empana JP, Schwartz PJ, Desnos M, Courbon D, Ducimetière P (2005) Heart-rate profile during exercise as a predictor of sudden death. N Engl J Med 352:1951–1958CrossRefPubMedGoogle Scholar
  11. 11.
    Straub RH, Baerwald CG, Wahle M, Jänig W (2005) Autonomic dysfunction in rheumatic diseases. Rheum Dis Clin North Am 31(1):61–75CrossRefPubMedGoogle Scholar
  12. 12.
    Esco MR, Olson MS, Williford HN, Blessing DL, Shannon D, Grandjean P (2010) The relationship between resting heart rate variability and heart rate recovery. Clin Auton Res 20(1):33–38CrossRefPubMedGoogle Scholar
  13. 13.
    Akdogan A, Calguneri M, Yavuz B, Arslan EB, Kalyoncu U, Sahiner L, Karadag O, Ertenli I, Kiraz S, Aytemir K, Akata D, Tokgozoglu L, Oto A (2006) Are familial Mediterranean fever (FMF) patients at increased risk for atherosclerosis? Impaired endothelial function and increased intima media thickness are found in FMF. J Am Coll Cardiol 48(11):2351–2353CrossRefPubMedGoogle Scholar
  14. 14.
    Caliskan M, Gullu H, Yilmaz S, Erdogan D, Unler GK, Ciftci O, Topcu S, Kayhan Z, Yucel E, Muderrisoglu H (2007) Impaired coronary microvascular function in familial Mediterranean fever. Atherosclerosis 195(2):161–167CrossRefGoogle Scholar
  15. 15.
    Akcay A, Acar G, Sayarlioglu M, Sokmen A, Kaya H, Ispiroglu M, Koroglu S (2009) QT dispersion and transmural dispersion of repolarization in patients with familial Mediterranean fever. Mod Rheumatol 19(5):550–555CrossRefPubMedGoogle Scholar
  16. 16.
    Langevitz P, Livneh A, Neumann L, Buskila D, Shemer J, Amolsky D, Pras M (2001) Prevalence of ischemic heart disease in patients with familial Mediterranean fever. Isr Med Assoc J 3:9–12PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Idris Ardic
    • 1
  • Mehmet Gungor Kaya
    • 1
  • Mikail Yarlioglues
    • 1
  • Orhan Dogdu
    • 1
  • Mehmet Celikbilek
    • 2
  • Mahmut Akpek
    • 1
  • Lutfi Akyol
    • 2
  • Edip Torun
    • 2
  1. 1.Department of CardiologyErciyes University School of Medicine KayseriKayseriTurkey
  2. 2.Department of GastroenterologyErciyes University School of Medicine KayseriKayseriTurkey

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