Hemodynamic determinants of physical training effectiveness in rheumatoid arthritis patients

Abstract

Aim. To investigate central and peripheral hemodynamics in rheumatoid arthritis (RA) patients during aerobic physical training (APT) program. Material and methods. The study included 20 women, aged 37-65 years, who suffered from sero-positive RA with mild-to-moderate activity, for at least 3 years. The control group included 35 healthy women aged 35-64, without any cardiovascular pathology. All participants underwent individual APT programs (gymnastics, brisk walking for 30-40 minutes per day) for 4 and 12 weeks. Six-minute walking test, echocardiography (EchoCG), post-occlusion test with reactive hyperemia were performed in all participants. Results. At 12 weeks, walking distance in 65minute walking test increased by 12,5% (p<0,05). Cardiac hemodynamics, according to EchoCG data, did not differ significantly from that in healthy controls, without any substantial systolic left ventricular (LV) dysfunction, local myocardial dyskinesia, or impaired peripheral vascular resistance registered. APT did not affect LV ejection fraction, end-systolic or end-diastolic LV volumes. Endothelial dysfunction was observed in 72% of RA patients. After 12-week APT course, significant improvement of endothelium-dependent vasodilatation (EDVD) was registered. In patients with initial endothelial dysfunction, EDVD increased by 83% (p<0,05), in patients with normal endothelial function – by 5% (p>0,05). Conclusion. Regular physical training in RA is essential for effective endothelium-dependent regulation of vascular tonus. Physical training does not affect central hemodynamics.

Keywords

• rheumatoid arthritis
• physical training
• aerobic physical training
• endothelial dysfunction
• endothelium-dependent vasodilatation