Heart rate recovery may predict the presence of coronary artery disease

Abstract

Objective: We investigated whether post-exercise first minute abnormal heart rate recovery (HRR1) helps to predict the presence and severity of CAD, because of some confounding data. Methods: A cross-sectional, retrospective study was performed. Two hundred individuals were included. Gensini scores and the number of coronary artery involvements were used to evaluate the severity of CAD. Student's t-test, Mann-Whitney U test and chi-square test were used for the analysis continuous and categorical data. Spearman's correlation analysis was used to determine whether there is correlation between Gensini scoring and HRR1. Univariate and multivariate logistic regression were used to determine predictors for abnormal HRR1. ROC curve analysis was performed to detect the best sensitivity and specificity value of HRR1 in predicting CAD presence. Results: Seventy subjects (35%) did not have CAD, and CAD was present in 130 patients (65%). HRR1 ≤21 beats with ROC analysis was determined to be the best cut off point. After adjustment between the two groups in terms of age, gender, diabetes, hypertension, dyslipidemia or smoking (all p>0.05), there was relationship CAD presence and abnormal HRR1 (OR=2.1, 95% CI: 1.1-3.9, p=0.02), but not between CAD severity and HRR1 (r=-0.13, p=0.112). The sensitivity, specificity, and the positive and negative predictive values of abnormal HRR1 ≤21 beats at first minute for predicting CAD presence were 76.1%, 41.3% (AUC=0.588, CI 95%: 0.517-0,657, p=0.039), 70.7% and 48.3%, respectively. Conclusion: In the study abnormal HRR1 predicted the presence of CAD, but not the severity of it. (Anadolu Kardiyol Derg 2014; 14: 351-6)

Deterioration of heart rate recovery index in patients with erectile dysfunction

“…Together, these findings indicate that parasympathetic system activity is suppressed during exercise and during the first minute of recovery and then steadily increases until 4 min post-exercise and remains stable until 10 min post-recovery (23, 26). Alterations in HRR indices have been previously investigated in heart failure (27)albeit not fully recognized, in the development of vascular complications in diabetes mellitus (28), ischemic heart disease (18, 22), obstructive sleep apnea (29), pulmonary arterial hypertension (30), systemic lupus erythematosus (31) and its impairment is an independent prognostic indicator for cardiovascular and all-cause mortality. Doğru et al (15) demonstrated decreased HRR values in patients with ED; however, HRR indices have not been separately evaluated.…”

“…Stress exercise test qualification was determined if the heart rate reached 85% of the target rate. Patients walked for a 2-min cool-down period at a 1.5-mph speed and 2.5% grade (18). The decrease in heart rate from the peak rate (HRR indices) was measured during the cool-down period at the 1 st , 2 nd , 3 rd , and 5 th minutes after cessation of the stress test and are denoted as HRR 1 , HRR 2 , HRR 3 , and HRR 5 , respectively.…”

Association between Cardiac Autonomic Neuropathy and Homocysteine Level in Patients with Type 2 Diabetes Mellitus

“…KHTİ efor testi sırasında ulaşılan en yüksek kalp hızından istirahat 1. dakika kalp hızı çıkarılarak tespit edildi. KON tanısı daha önce tanımlandığı şekilde KHTİ'nin ≤ 21 bulunması ile konuldu (10) .…”

Heart rate recovery and methodological issues

“…We read with great interest the article, entitled “Heart rate recovery may predict the presence of coronary artery disease” by Akyüz et al (1) published in Anatolian J Cardiol 2014; 14: 351-6.…”