Heart Rate Recovery and Treadmill Exercise Score as Predictors of Mortality in Patients Referred for Exercise ECG

Abstract

In this cohort of patients referred specifically for exercise electrocardiography, both abnormal heart rate recovery and treadmill exercise score were independent predictors of mortality. Heart rate recovery appears to provide additional prognostic information to the established treadmill exercise score and should be considered for routine incorporation into exercise test interpretation. JAMA. 2000;284:1392-1398.

Heart rate recovery after exercise: relations to heart rate variability and complexity

“…Slower changes in the stimuli to metaboreceptors and baroreceptors accompanying clearance of metabolites and delayed elimination of body heat and catecholamines are thought to be other factors contributing to heart rate recovery after physical activity. Nevertheless, parasympathetic activation is considered to be the main mechanism underlying exponential cardiodeceleration after exercise (1)(2)(3)(4).…”

“…Recently, a delayed decrease in heart rate during the first minute after exercise has been suggested to be a powerful and independent predictor of all-cause mortality (3,6,7).…”

Electrical stimulation versus kinesitherapy in improving functional fitness in older women: A randomized controlled trial

“…This might also be relevant in limiting the cardiovascular risk in this patient population. Indeed, HR recovery from an exercise test is commonly considered as one of the most important predictors of cardiovascular mortality (Nishime et al, 2000). Similarly, although submaximal, the 6MWT and other similar exercise tests demonstrated to detect exercise capacity as determined by maximal cardiopulmonary exercise testing, and the distance walked in 6 min showed a strong, independent association with mortality Miyamoto et al, 2000).…”

Blood pressure and cardiac autonomic modulation at rest, during exercise and recovery time in the young overweight

“…Moreover, the literature shows an inverse relation between the HRR and mortality risk; thus, the smaller reduction of the heart rate in recovery time, a higher prevalence of autonomic dysfunction, especially in its parasympathetic area, seen in patients with coronary disease, chronic cardiac insufficiency, hypertension, myocardial infarction and mellitus diabetes (Cole et al, 1999;Cole, Foody, Blackstone, & Lauer, 2000;Imai et al, 1994;Lima, Oliveira & Ferreira-Júnior, 2012;Nishime, Cole, Blackstone, Pashkow & Lauer, 2000;Perini, Orizio, Comand, Castellano & Beschi, 1989). Accordingly, the HRR measurement provides information about the integrity and functioning of the autonomic nervous system, as well as the hemodynamic variables behavior in the recovery phase, and also showing clinical and sporting applications.…”