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/m 2 vs. 29.1 ± 2.9 kg/m 2, 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.
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