Fibromyalgia Patients Display Blunted Cardiovascular Responses During Repeated Exercise Stress

Document Type

Conference Presentation

Department

Health, Exercise, and Sport Sciences Department

Conference Title

American College of Sports Medicine - Medicine & Science in Sports & Exercise conference

Organization

American College of Sports Medicine

Location

San Francisco, CA

Date of Presentation

5-29-2020

Journal Publication

Medicine & Science in Sports & Exercise

ISSN

0195-9131

DOI

10.1249/01.mss.0000682924.70475.2a

Volume

52

Issue

7S

First Page

710

Abstract

Fibromyalgia syndrome (FMS) affects nearly 10 million people in the United States and an estimated 6% of the world’s population. FMS is idiopathic and characterized by severe pain (typically in joints and musculature), fatigue, and malaise. Pain and fatigue may limit physical activity, but other factors such as post-exertional malaise, may also contribute. PURPOSE: To examine exertional and post-exertional cardiovascular responses. METHODS: Thirty-five patients with fibromyalgia and 8 sedentary controls performed two cardiopulmonary exercise tests (CPET) to maximal exertion separated by 24 hours. Heart rate (HR) was measured continuously via ECG and blood pressure (BP) was recorded every two minutes. Independent samples T-tests compared differences between FMS patients and sedentary controls. Multiple linear regressions observed the effects of FMS on cardiovascular statistics (HR, SBP, Rate pressure product; RPP) at anaerobic threshold (AT) and VO2 max (peak), controlling for confounding variables (age, sex, BMI, workload, and any additional medical conditions). RESULTS: Patients were 44.6±9.8 years old, 27.5±6.1 kg/m2 BMI, and mostly female (88.4%). FMS and sedentary controls did not differ in age or BMI. FMS and sedentary controls did not differ in VO2 (p=0.62), workload (p=0.29), SBP (p=0.44), DBP (p=0.989), RPP (p=0.05) during test 1. At AT, FMS did not influence HR (β=-3.71, p=0.53), SBP (β=-3.94, p= 0.67), or RPP (β=-1,478.37, p= 0.35) at test 1, but did at test 2 for HR (β= -20.69, p=0.003) and RPP (β=-5,035.79, p=0.003). When comparing test 1 to test 2 with the same variables, FMS influenced both HR (β= -15.956, p=0.001) and RPP (β=-3,227.35, p=0.01), but not SBP (β=-3.60, p= 0.686). At peak, FMS influenced HR (β=-23.80, p=0.012) and RPP (β=-5,078.36, p=0.040) for test 1, but did not influence SBP (β=-2.86, p=0.786). This was also observed during test 2 for HR (β=-23.30, p=0.004), RPP (β=-7,373.82, p=0.008), and SBP (β=-13.27, p=0.294). When comparing test 1 to test 2 at peak, FMS did not influence HR (β=-0.31, p=0.974), or RPP (β=-2,453.78, p=0.175), but did influence SBP (β=-14.72, p=0.029). CONCLUSION: Post-exertional effects blunt the cardiovascular responses to exercise in FMS. This post-exertional effect has not been clearly elucidated in this illness and may help in understanding the illness.

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