The relevance of performing exercise test before starting supervised physical exercise in asymptomatic cardiovascular patients with rheumatic diseases

The relevance of performing exercise test before starting supervised physical exercise in asymptomatic cardiovascular patients with rheumatic diseases

Author Klemz, Barbara Nascimento de Carvalho Autor UNIFESP Google Scholar
Reis-Neto, Edgard Torres dos Autor UNIFESP Google Scholar
Jennings, Fabio Autor UNIFESP Google Scholar
Siqueira, Usmary Sardinha Autor UNIFESP Google Scholar
Klemz, Fabio Kadratz Google Scholar
Costa Pinheiro, Helder Henrique Google Scholar
Sato, Emilia Inoue Autor UNIFESP Google Scholar
Natour, Jamil Autor UNIFESP Google Scholar
Szejnfeld, Vera Lucia Autor UNIFESP Google Scholar
Pinheiro, Marcelo de Medeiros Autor UNIFESP Google Scholar
Abstract Objectives. To evaluate the impact and risk factors associated with an abnormal exercise test ( ET) in systemic inflammatory rheumatic disease ( SIRD) patients before commencing supervised physical exercise. Methods. A total of 235 SIRD patients were enrolled in three controlled clinical trials, including 103 RA, 42 SLE and 57 AS patients. The control group consisted of 231 healthy, sedentary subjects matched for age, gender and BMI. All performed an ET, according to Bruce's or Ellestad's protocol. Cardiovascular disease risk factors, medications, comorbidities and details of each SIRD were assessed. Results. SIRD patients had a higher percentage of abnormal ETs compared with the control group, especially exercise hypertensive behaviour, higher oxygen consumption, higher resting heart rate and heart rate at the first minute of recovery, and chronotropic incompetence (C-Inc) (P < 0.001). The disease itself was involved with higher likelihood of having an abnormal ET [Odds ratio (OR) = 12.0, 95% CI: 2.5, 56.7

P = 0.002 for SLE

OR = 13.56, 95% CI: 6.16, 29.8

P < 0.001 for RA

and OR = 4.31, 95% CI: 1.17, 15.8

P = 0.028, for AS]. Each 10-year increment of age increased the chance of having an abnormal ET by 13% (P = 0.008) in AS patients, as well as hypertension (OR = 7.14, 95% CI: 1.61, 31.6

P = 0.01). Regarding C-Inc, age played a protective role (OR = 0.88, 95% CI: 0.78, 0.99

P = 0.043) in SLE, and ASDAS-ESR was associated with a higher risk in AS (OR = 2.73, 95% CI: 0.93, 8.0

P = 0.067). Conclusion. Our results showed a higher prevalence of abnormal ETs in asymptomatic cardiovascular SIRD patients, and the disease itself was associated with a higher likelihood of having an abnormal test, emphasizing the relevance and need of performing it before starting supervised physical exercise.
Keywords rheumatoid arthritis
systemic lupus erythematosus
ankylosing spondylitis
xmlui.dri2xhtml.METS-1.0.item-coverage Oxford
Language English
Date 2016
Published in Rheumatology. Oxford, v. 55, n. 11, p. 1978-1986, 2016.
ISSN 1462-0324 (Sherpa/Romeo, impact factor)
Publisher Oxford Univ Press
Extent 1978-1986
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000388555100010

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