PT - JOURNAL ARTICLE AU - Orhan Dogdu AU - Mikail Yarlioglues AU - Mehmet Gungor Kaya AU - Idris Ardic AU - Nilufer Oguzhan AU - Mahmut Akpek AU - Omer Sahin AU - Lutfi Akyol AU - Saban Kelesoglu AU - Fatih Koc AU - Ibrahim Ozdogru AU - Abdurrahman Oguzhan TI - Deterioration of Heart Rate Recovery Index in Patients with Systemic Lupus Erythematosus AID - 10.3899/jrheum.100163 DP - 2010 Sep 01 TA - The Journal of Rheumatology PG - jrheum.100163 4099 - http://www.jrheum.org/content/early/2010/08/29/jrheum.100163.short 4100 - http://www.jrheum.org/content/early/2010/08/29/jrheum.100163.full AB - Objective Systemic lupus erythematosus (SLE) is an autoimmune disorder resulting in multisystemic inflammatory damage. It is reported that cardiovascular diseases (CVD) are responsible for 20%–30% of deaths in patients with SLE. 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 the heart rate recovery index in patients with SLE. Methods The study population included 48 patients with SLE (35 women, mean age 46.3 ± 12.8 yrs, mean disease duration 6.0 ± 2.3 yrs) and 44 healthy controls (30 women, mean age 45.7 ± 12.9 yrs). Basal electrocardiography, echocardiography, and treadmill exercise testing were performed on all patients and controls. The heart rate recovery index was defined as the reduction in the heart rate from the rate at peak exercise to the rate at the first minute (HRR1), second minute (HRR2), third minute (HRR3), and fifth minute (HRR5) after stopping exercise stress testing. Results There were significant differences in HRR1 and HRR2 indices between patients with SLE and the control group (24.1 ± 6.5 vs 33.3 ± 9.3; p < 0.001, and 44.6 ± 13.3 vs 53.7 ± 9.9; p < 0.001, respectively). Similarly, HRR3 and HRR5 indices of the recovery period were lower in patients with SLE, compared with indices in the control group (57.6 ± 13.0 vs 64.9 ± 11.7; p = 0.006, and 67.2 ± 12.3 vs 75.0 ± 15.4; p = 0.009, respectively). Effort capacity was markedly lower (9.0 ± 1.9 vs 11.1 ± 2.3 metabolic equivalents; p = 0.001, respectively) among the patients with SLE. Conclusion The heart rate recovery index is deteriorated in patients with SLE. When the prognostic significance of the heart rate recovery index is considered, these results may contribute to explain the increased occurrence of cardiac death. It points to the importance of the heart rate recovery index in the identification of high-risk patients.