Heart-Rate Profile During Exercise as a Predictor of Sudden Death

Jouven, Xavier; Empana, Jean Philippe; Schwartz, Peter J.; Desnos, Michel; Courbon, Dominique; Ducimetière, Pierre

doi:10.1016/j.accreview.2005.08.046

Cited by 82 publications

(135 citation statements)

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“…In contrast, impaired HRR is associated with higher all-cause and CV mortality, particularly due to increased likelihood of ventricular arrhythmias. 63 The prognostic power of HRR is even more evident when combined with CPX responses, such as peak VO 2 and the VE/VCO 2 slope. 64 Notably, HRR remains a sensitive predictor of risk even in subjects who are taking beta-blockers, 65 although very low maximum heart rates may diminish sensitivity to detect these physiological properties as a low maximum HR may diminish the magnitude of deceleration.…”

Section: Electrocardiogrammentioning

confidence: 98%

Cardiopulmonary Exercise Testing: Relevant but Underused

Forman

Myers

Lavie

et al. 2010

Postgraduate Medicine

106

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Cardiopulmonary exercise testing (CPX) is a relatively old technology, but has sustained relevance for many primary care clinical scenarios in which it is, ironically, rarely considered. Advancing computer technology has made CPX easier to administer and interpret at a time when our aging population is more prone to comorbidities and higher prevalence of nonspecific symptoms of exercise intolerance and dyspnea, for which CPX is particularly useful diagnostically and prognostically. These discrepancies in application are compounded by patterns in which CPX is often administered and interpreted by cardiology, pulmonary, or exercise specialists who limit their assessments to the priorities of their own discipline, thereby missing opportunities to distinguish symptom origins. When used properly, CPX enables the physician to assess fitness and uncover cardiopulmonary issues at earlier phases of work-up, which would therefore be especially useful for primary care physicians. In this article, we provide an overview of CPX principles and testing logistics, as well as some of the clinical contexts in which it can enhance patient care.

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Section: Electrocardiogrammentioning

confidence: 98%

Cardiopulmonary Exercise Testing: Relevant but Underused

Forman

Myers

Lavie

et al. 2010

Postgraduate Medicine

106

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“…(15)(16)(17). Previous studies have shown that abnormal HRR is associated with both cardiovascular and all-cause mortality (18)(19)(20)(21)(22)(23)(24)(25)(26).…”

Section: Discussionmentioning

confidence: 95%

“…Previous studies have shown that abnormal HRR is associated with sudden cardiac death and CV events (19)(20)(21)(22)(23)(24)(25). Impaired HRR is an important predictor of overall mortality in healthy subjects (26).…”

Section: Ankara Numune Education and Researchmentioning

confidence: 99%

Impaired Heart Rate Recovery in Patients with Impaired Glucose Tolerance

Celebi¹

2014

Acta Endo (Buc)

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Background. Heart rate recovery after exercise is a predictor of mortality that is thought to reflect autonomic imbalance. The association between heart rate recovery and prediabetic stages is unclear.Aim. To evaluate the heart rate recovery in patients with diabetes and prediabetes.Patients and Methods. Thirtyfive patients with impaired fasting glucose, 32 patients with impaired glucose tolerance, and 34 patients with diabetes mellitus were included. The control group consisted of 30 healthy individuals. All study participants underwent a maximal graded exercise test, and heart rate recovery was calculated by subtracting the 1 st , 2 nd and 3 rd minute heart rates from the maximum heart rate achieved during the stress testing.Results. The 1 st , 2 nd and 3 rd minute heart rate recovery values of the diabetes mellitus, impaired glucose tolerance and impaired fasting glucose groups were significantly lower than that of the control group. For the 1 st minute, heart rate recovery values of the diabetes mellitus patients were significantly lower than that of the control group (19.8±9.4 vs. 25.4±9.9, p<0.001) and the impaired fasting glucose group (19.8±9.4 vs. 22.1±9.3, p<0.01), and the 1 st minute heart rate recovery of the diabetes mellitus patients was similar to that of the impaired glucose tolerance group (19.8±9.4 vs. 20.7±5.8, p=0.88). Similar results were obtained in the 2 nd and 3 rd minute heart rate recovery measurements.The heart rate recovery values of the impaired fasting glucose were significantly higher than those of the diabetes mellitus and impaired glucose tolerance patients. In comparing the impaired glucose tolerance and diabetes mellitus groups in terms of heart rate recovery values, there was no significant difference.

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“…[16,23] Predisposition to fatal arrhythmias, sudden cardiac death, and significant coronary artery disease has been postulated as potential mediators of these outcomes. [4,24] HRR appears to measure the capacity of the cardiovascular system to reverse the vagal withdrawal that occurs during exercise. [25,26] Abnormalities in this reversal, as indicated by abnormal HRR, are associated with mortality in asymptomatic patients, patients….… undergoing coronary angiography, stress echocardiography, and nuclear perfusion imaging.…”

Section: Discussionmentioning

confidence: 99%