Tolerance to exercise in adolescents with rheumatic diseases taking into account systolic heart function

Abstract

Aim: to determine the systolic heart function and adaptive capabilities to physical activity in adolescents with juvenile idiopathic arthritis and systemic lupus erythematosus. Materials and methods. We examined 72 adolescents with RD at the age of 10–18 (13.11 ± 0.89) years, 58 were girls and 14 were boys. The control group consisted of 46 healthy adolescents of the corresponding age (14.73 ± 0.32 years) and gender (29 girls and 17 boys). An ultrasound examination of the heart using a General Electric LOGIO V2 apparatus (USA) was performed for all patients. The six-minute walk test was performed to determine the tolerance to minimal physical activity. Before the test and after completion during the first minute of the recovery period, heart rate was calculated, blood pressure was measured and the Allgower’s index was calculated. The 6 minute walking distance was measured in meters. Results. It was found that adolescents with RD had a significant decrease in EFrv against the background of a significant increase in SVrv and MVCrv, which was accompanied by higher HR values. In patients with JIA, reliably lower EF of both ventricles of the heart was established against the background of significantly higher heart rate values and a decrease in SVlv and MVClv, while SVrv and MVCrv were significantly higher. When analyzing 6MWT indicators, the distance was significantly shorter in adolescents with RD, and the percentage of increase in heart rate after the test was higher. Allgower’s index was significantly higher before 6MWT and significantly increased after the test. In adolescents with low EFrv, there was a significant decrease in SVrv and MVCrv against the background of significantly low HR values, but the Allgower’s index after 6MWT was significantly higher. Conclusions. In adolescents with RD, while the systolic function of the left ventricle is preserved, there is a decrease in the systolic function of the right ventricle of the heart, an increase in SVrv and MVCrv on the background of an increase in heart rate. Tolerance to physical activity remains within normal limits due to a significant increase in the activity of regulatory systems. With a progressive decrease in the systolic function of the right ventricle, a decrease in its stroke and minute volumes was established, which may indicate the participation of other regulatory systems in adequate support of the circulatory system.

Keywords

• myocardial systolic function
• rheumatic diseases
• exercise tolerance
• adolescents