Juvenile fibromyalgia syndrome: Blunted heart rate response and cardiac autonomic dysfunction at diagnosis

Juvenile fibromyalgia syndrome: Blunted heart rate response and cardiac autonomic dysfunction at diagnosis

Author Maia, Magda M. Google Scholar
Gualano, Bruno Google Scholar
Sa-Pinto, Ana L. Google Scholar
Sallum, Adriana M. E. Google Scholar
Pereira, Rosa M. R. Google Scholar
Len, Claudio Arnaldo Autor UNIFESP Google Scholar
Terreri, Maria Teresa Ramos Ascensão Autor UNIFESP Google Scholar
Barbosa, Cassia M. Google Scholar
Roschel, Hamilton Google Scholar
Silva, Clovis A. Google Scholar
Abstract Objective: To assess aerobic capacity and cardiac autonomic modulation in juvenile fibromyalgia syndrome (JFM) patients at diagnosis in response to graded exercise text. Methods: A multicenter cross-sectional study included 25 JFM patients and 25 healthy controls. Both groups participated only in physical education classes at school. A treadmill graded cardiorespiratory test was performed and the heart-rate (HR) response during exercise was evaluated by the chronotropic reserve (CR). Pain, functional ability, and health-related quality of life (HRQL) were assessed. Results: The median current age was similar in JFM and controls (15 vs. 15 years, p = 0.890), as well as body mass index (p = 0.332), female gender (p = 1.000), and Tanner stages (p = 0.822). The medians of HRQL parameters (total score/physical health/psychosocial health) were significantly lower in JFM vs. controls according to patient and parent self-reports (p < 0.001). The median of peak HR [181 (150-198) vs. 197 (181-202) bpm, p < 0.001], chronotropic reserve [84 (53-98) vs. 99 (84-103)%, p < 0.001], and resting to peal< [96 (65-181) vs. 127 (61-185) bpm, p = 0.010] were significantly lower in JFM compared to controls. The median of Delta EIRR1 [15 (3-39) vs. 35 (9-52) bpm, p < 0.0011, Delta FIRR2 [37 (20-57) vs. 51 (32-94) bpm, p < 0.001], peak VO2 [32.34 (24.24-39.65) vs. 36A (28.56-52.71) ml/kg/min, p = 0.005], peak speed [5 (4-6.3) vs. 5.9 (4.0-6.3) mph, p = 0.001], time to exhaustion [11.5 (8.5-14.5) vs. 14 (11-18) min, p < 0.0011, and working capacity on power [3.37 (2.04-5.6) vs. 3.89 (2.91-6.55) W/kg, p = 0.006] were significantly lower in JFM compared to controls. The frequency of chronotropic incompetence (<= 80%) was significantly higher in JFM vs. controls (p = 0.0006). Conclusions: This study identified chronotropic incompetence and delayed HR recovery in JFM patients, indicating autonomic dysfunction. Aerobic exercise training should be considered in all JFM patients and may improve cardiac autonomic impairment, thus reducing cardiovascular risk. (C) 2016 Elsevier Inc. All rights reserved.
Keywords Juvenile fibromyalgia syndrome
Health-related quality of life
Chronotropic reserve
Autonomic dysfunction
xmlui.dri2xhtml.METS-1.0.item-coverage Philadelphia
Language English
Sponsor Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
Federico Foundation
Nucleo de Apoio a Pesquisa "Saude da Crianca e do Adolescente" da USP (NAP-CriAd)
Grant number CNPq: 303422/2015-7-1A
Date 2016
Published in Seminars In Arthritis And Rheumatism. Philadelphia, v. 46, n. 3, p. 338-343, 2016.
ISSN 0049-0172 (Sherpa/Romeo, impact factor)
Publisher W B Saunders Co-Elsevier Inc
Extent 338-343
Origin http://dx.doi.org/10.1016/j.semarthrit.2016.07.002
Access rights Closed access
Type Article
Web of Science ID WOS:000390979200011
URI https://repositorio.unifesp.br/handle/11600/56616

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