Abnormal heart rate recovery after maximal cardiopulmonary exercise stress testing in young overweight women with polycystic ovary syndrome

Abstract

Heart rate recovery (HRR) is a measure derived from exercise test, defined as the fall in heart rate during the first minute after maximal exercise. Abnormal HRR is a measure of autonomic dysfunction associated with an increased mortality. This study was performed to evaluate the HRR in polycystic ovary syndrome (PCOS). Prospective controlled clinical study. Seventy-five PCOS women compared to 75 healthy women matched for age (21.7 +/- 2.1 years vs. 21.9 +/- 1.8 years, respectively) and body mass index (BMI) (29.0 +/- 2.6 kg/m(2) vs. 29.1 +/- 2.9 kg/m(2), respectively). Subjects were studied for their hormonal and metabolic profile, and underwent cardiopulmonary exercise test (CPX). PCOS women showed a significantly reduced HRR (12.9 +/- 1.8 vs. 20.4 +/- 3.1 beats/min, P < 0.001) compared to healthy controls, an impairment in maximal oxygen consumption (18.0 +/- 2.3 ml/kg/min vs. 29.3 +/- 3.9 ml/kg/min) and in oxygen consumption at anaerobic threshold (13.6 +/- 2.6 ml/kg/min vs. 24.2 +/- 3.0 ml/kg/min). In PCOS women, abnormal HRR was inversely correlated to BMI (r = -0.582, P < 0.001) and to the area under the curve for insulin (r = -0.596, P < 0.001). Our data demonstrate an abnormal HRR after maximal CPX in young overweight PCOS patients, and that HRR should be investigated as a further potential marker of increased cardiovascular risk in PCOS.