Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Dysautonomia and Chronotropic Incompetence in Fibromyalgia.
Ribeiro1, Roberta P. C., Dassouki2, Thalita, Perandini2, Luiz A., Artioli1, Guilherme G., Calich3, Ana L. G., Pinto4, Ana Lucia S., Roschel5, Hamilton
University of Sao Paulo,, Sao Paulo, Brazil
University of Sao Paulo, Rheumatology Division, LACRE, Sao Paulo, Brazil
University of Sao Paulo, Sao Paulo, Brazil
University of Sao Paulo, School of Medicine, Rheumatology Division, LACRE, Sao Paulo, Brazil
University of Sao Paulo, School of Physical Education and Sport, Sao Paulo, Brazil
University of Sao Paulo, School of Medicine, Rheumatology Division, Sao Paulo, Brazil
Faculdade de Medicina da Universidade de São Paulo (FMUSP), Sao Paulo, Brazil
University of Sao Paulo,School of Physical Education and Sport, Sao Paulo, Brazil
The understanding regarding fibromylgia (FM) physiopathology has substantially advanced, with a growing body of evidence suggesting that autonomic nervous system dysfunction (also called dysautonomia) plays a role in this disease. We aimed to gather knowledge on the autonomic modulation in patients with fibromyalgia (FM) in response to exercise and to investigate whether this population suffers from chronotropic incompetence.
Fourteen women with FM (age: 46 ± 10 years; BMI: 26.6 ± 5.2 kg/m2) and 14 gender-, BMI- (25.4 ± 4.9 kg/m2), and age-matched (age: 41 ± 14 years) healthy individuals (CTRL) took part in this cross-sectional study. A treadmill cardiorespiratory test was performed and heart-hate (HR) response during exercise was evaluated by the chronotropic reserve (CR). HR recovery (DHRR) was defined as the difference between HR at peak exercise and at both first (DHRR1) and second (DHRR2) minutes after the exercise test.
FM patients presented lower peak VO2 when compared with healthy subjects (22 ± 3 vs. CTRL: 32 ± 9 mL/kg/min, respectively; p<0.001). Additionally, FM patients demonstrated lower CR (72.5 ± 19.4 vs. CTRL: 106.1 ± 21.7, p < 0.001), DHRR1 (24.5 ± 12.2 vs. CTRL: 32.6 ± 9.1, p = 0.059) and DHRR2 (34.3 ± 14.2 vs. CTRL: 50.8 ± 10.8, p = 0.002) than their healthy peers. The prevalence of chronotropic incompetence was 57.1% among patients with FM.
The majority of the patients with FM undertaken a graded exercise test presented chronotropic incompetence and delayed HR recovery, both being indicative of dysautonomia and higher risk of events.
To cite this abstract, please use the following information:
Ribeiro, Roberta P. C., Dassouki, Thalita, Perandini, Luiz A., Artioli, Guilherme G., Calich, Ana L. G., Pinto, Ana Lucia S., et al; Dysautonomia and Chronotropic Incompetence in Fibromyalgia. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :1566