Cardiovascular Autonomic Function Changes and Predictors During a 2-Year Physical Activity Program in Rheumatoid...

Area of Science:

• Rheumatology
• Cardiology
• Exercise Physiology

Background:

• Chronic inflammation in rheumatoid arthritis (RA) is linked to autonomic dysfunction and increased cardiovascular disease (CVD) risk.
• Autonomic nervous system (ANS) activity, particularly parasympathetic tone, can be assessed using heart rate recovery (HRR) post-exercise.
• Physical activity programs aim to improve ANS function and mitigate CVD risk in RA patients.

Purpose of the Study:

• To evaluate changes in HRR after a 2-year physical activity program in RA patients.
• To identify predictive factors for HRR changes during guided and unsupervised exercise phases.
• To assess the potential of HRR as a marker for physical activity effectiveness in RA.

Main Methods:

• A substudy of the PARA 2010 trial involving 25 RA participants.
• A 2-year program including 1 year of guided exercise and 1 year of unsupervised activity.
• Maximal exercise electrocardiogram (ECG) and HRR measurements at baseline, year 1, and year 2; machine learning models used for prediction.

Main Results:

• Heart rate recovery (HRR1 and HRR2) significantly increased after 1 year of guided physical activity.
• HRR significantly decreased from year 1 to year 2 with unsupervised physical activity.
• Exercise blood pressure response, low BMI, and muscular strength predicted HRR changes in both guided and unsupervised phases.

Conclusions:

• Guided physical activity positively impacts ANS function in RA patients, as indicated by HRR improvements.
• Machine learning effectively identified predictors of HRR response to exercise interventions.
• HRR is a valuable clinical marker for assessing physical activity effectiveness and CVD risk in RA patients, especially those who are inactive or have high CVD risk.