Note: Via Adrienne Dwello - New research suggests that fibromyalgia
(FMS) may be tied to cardiac abnormalities tied to the autonomic
nervous system.
The autonomic nervous system regulates heart rate, blood pressure and
blood vessel constriction. Prior research links autonomic nervous
system dysfunction to fibromyalgia.
In this small study, women with FMS exercised on a treadmill and
researchers looked at several measures of autonomic cardiac function.
They found FMS participants:
=95 Had lower oxygen consumption than healthy subjects;
=95 Took longer to return to resting heart rates after exercise;
=95 Had higher rates of chronotropic incompetence.
Chronotropic incompetence (CI) is an inability for the body to raise
the heart rate like it's supposed to during exertion. It can cause
fatigue in response to even mild exertion, which is a common symptom
of FMS.
CI is common in elderly people and can be treated with a
rate-responsive pacemaker. Doctors can diagnose CI with a stress test.
Researchers concluded that FMS may raise the risk of autonomic cardiac
abnormalities, which may mean a higher risk of potentially fatal
cardiovascular problems. However, this was a small study and further
research is needed to confirm the relationship.
Arthritis Res Ther. 2011 Nov 18;13(6):R190. [Epub ahead of print]
Cardiac autonomic impairment and chronotropic incompetence in fibromyalgia.
Ribeiro RP, Roschel H, Artioli GG, Dassouki T, Perandini LA, Calich
AL, Pinto AL, Lima FR, Bonfa E, Gualano B.
INTRODUCTION:
We aimed to gather knowledge on the cardiac autonomic modulation in
patients with fibromyalgia (FM) in response to exercise and to
investigate whether this population suffers from chronotropic
incompetence (CI).
METHODS:
Fourteen women with FM (age: 46 +/- 3 years; BMI: 26.6 +/- 1.4 kg/m^2)
and 14 gender-, BMI- (25.4 +/- 1.3 kg/m^2), and age-matched (age: 41
+/- 4 years) healthy individuals (CTRL) took part in this
cross-sectional study. A treadmill cardiorespiratory test was
performed and heart-rate (HR) response during exercise was evaluated
by the chronotropic reserve. HR recovery (deltaHRR) was defined as the
difference between HR at peak exercise and at both first (deltaHRR1)
and second (deltaHRR2) minutes after the exercise test.
RESULTS:
FM patients presented lower maximal oxygen consumption (VO2 max) when
compared with healthy subjects (22 +/- 1 versus CTRL: 32 +/- 2
mL/kg/min, respectively; P<0.001). Additionally, FM patients presented
lower chronotropic reserve (72.5 +/- 5 versus CTRL: 106.1 +/- 6, P <
0.001), deltaHRR1 (24.5 +/- 3 versus CTRL: 32.6 +/- 2, P =3D 0.059) and
deltaHRR2 (34.3 +/- 4 versus CTRL: 50.8 +/- 3, P =3D 0.002) than their
healthy peers. The prevalence of CI was 57.1% among patients with FM.
CONCLUSIONS:
Patients with FM who undertook a graded exercise test may present CI
and delayed HR recovery, both being indicative of cardiac autonomic
impairment and higher risk of cardiovascular events and mortality.
The full study can be found here:
http://arthritis-research.com/content/13/6/R190/abstract
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