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


Francesco Orio, Faculty of Exercise Sciences, University of Naples ‘Parthenope’, Naples and Department of Molecular & Clinical Endocrinology and Oncology, University of Naples ‘Federico II’, Via S. Pansini 5, 80131 Naples, Italy. Tel: +39 3477676883; Fax: +39 0892574878; E-mail: francescoorio@virgilio.it


Objective  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).

Design  Prospective controlled clinical study.

Patients  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/m2 vs. 29·1 ± 2·9 kg/m2, respectively).

Measurements  Subjects were studied for their hormonal and metabolic profile, and underwent cardiopulmonary exercise test (CPX).

Results  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).

Conclusions  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.