Impaired heart rate recovery after sub-maximal physical exercise in people with multiple sclerosis.


Journal

Multiple sclerosis and related disorders
ISSN: 2211-0356
Titre abrégé: Mult Scler Relat Disord
Pays: Netherlands
ID NLM: 101580247

Informations de publication

Date de publication:
May 2020
Historique:
received: 26 03 2019
revised: 07 01 2020
accepted: 18 01 2020
pubmed: 8 2 2020
medline: 26 1 2021
entrez: 8 2 2020
Statut: ppublish

Résumé

Heart Rate Recovery (HRR) after a physical exercise has been poorly investigated in people with multiple sclerosis (PwMS). To evaluate the kinetics of HRR and its autonomic modulation in PwMS and to elucidate the interplay between HRR and subjective fatigue. ECG was digitally acquired during rest (5 min), submaximal exercise (4 min at 10 W of upper limb cycling) and recovery (3 min) in 17 PwMS (EDSS: 5.9 ± 1.2, mean±standard deviation) and 17 healthy control (HC) subjects. Short-term (first 30 s) and long-term (up to180 s) validated indices of HRR were calculated. The time course of the parasympathetic index of heart rate variability RMSSD (Root Mean Square of Successive Differences) was computed every 30 s of recovery. Subjective fatigue was evaluated by the Borg scale applied to breathing and upper limbs. In comparison with HC, the short-term HRR indices were significantly slower (P < 0.05) in PwMS, whereas the long-term ones did not. The time course of RMSSD was significantly different in PwMS (P < 0.05). HRR and HRV indexes did not correlate with fatigue perception and baseline HRV values. The cardiac parasympathetic reactivation from a submaximal exercise was blunted in PwMS, thereby slowing the short-term phase of HRR. This may contribute to the higher cardiovascular risk in PwMS, but the mechanism needs further investigation. The parasympathetic impairment during post-exercise HR reactivation cannot be predicted by baseline HRV values and may therefore be revealed only by an appropriate provocative low-intensity physical test.

Sections du résumé

BACKGROUND BACKGROUND
Heart Rate Recovery (HRR) after a physical exercise has been poorly investigated in people with multiple sclerosis (PwMS).
OBJECTIVE OBJECTIVE
To evaluate the kinetics of HRR and its autonomic modulation in PwMS and to elucidate the interplay between HRR and subjective fatigue.
METHODS METHODS
ECG was digitally acquired during rest (5 min), submaximal exercise (4 min at 10 W of upper limb cycling) and recovery (3 min) in 17 PwMS (EDSS: 5.9 ± 1.2, mean±standard deviation) and 17 healthy control (HC) subjects. Short-term (first 30 s) and long-term (up to180 s) validated indices of HRR were calculated. The time course of the parasympathetic index of heart rate variability RMSSD (Root Mean Square of Successive Differences) was computed every 30 s of recovery. Subjective fatigue was evaluated by the Borg scale applied to breathing and upper limbs.
RESULTS RESULTS
In comparison with HC, the short-term HRR indices were significantly slower (P < 0.05) in PwMS, whereas the long-term ones did not. The time course of RMSSD was significantly different in PwMS (P < 0.05). HRR and HRV indexes did not correlate with fatigue perception and baseline HRV values.
CONCLUSION CONCLUSIONS
The cardiac parasympathetic reactivation from a submaximal exercise was blunted in PwMS, thereby slowing the short-term phase of HRR. This may contribute to the higher cardiovascular risk in PwMS, but the mechanism needs further investigation. The parasympathetic impairment during post-exercise HR reactivation cannot be predicted by baseline HRV values and may therefore be revealed only by an appropriate provocative low-intensity physical test.

Identifiants

pubmed: 32032843
pii: S2211-0348(20)30036-5
doi: 10.1016/j.msard.2020.101960
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

101960

Informations de copyright

Copyright © 2020 Elsevier B.V. All rights reserved.

Auteurs

Susanna Rampichini (S)

Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.

Elisa Gervasoni (E)

IRCCS Fondazione Don Carlo Gnocchi, Milano, Italy.

Davide Cattaneo (D)

IRCCS Fondazione Don Carlo Gnocchi, Milano, Italy. Electronic address: dcattaneo@dongnocchi.it.

Marco Rovaris (M)

IRCCS Fondazione Don Carlo Gnocchi, Milano, Italy.

Cristina Grosso (C)

IRCCS Fondazione Don Carlo Gnocchi, Milano, Italy.

Martina Anna Maggioni (MA)

Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy; Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Physiology, Center for Space Medicine and Extreme Environments, Charitéplatz 1, 10117 Berlin, Germany.

Giampiero Merati (G)

Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy; IRCCS Fondazione Don Carlo Gnocchi, Milano, Italy.

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Classifications MeSH