Nonaka Akiko, Shiotani Hideyuki, Kitano Kimiko, Yokoyama Mitsuhiro
Department of Cardiovascular and Respiratory Medicine, Hyogo Cancer Center, Hyogo, Japan.
Kobe J Med Sci. 2007;53(3):93-8.
Heart rate recovery after exercise is an independent prognostic indicator for cardiovascular and all-cause mortality. The purpose of this study was to clarify the clinical determinants of heart rate recovery.
We examined 114 consecutive male patients who underwent exercise myocardial perfusion single-photon emission computed tomography and echocardiography for the evaluation of suspected coronary artery disease. Heart rate recovery was obtained from the subtraction of heart rate in the first minute of recovery after exercise from maximal heart rate during exercise. Abnormal heart rate recovery was present in 50 patients (43.9%). Patients with abnormal heat rate recovery were more likely to have diabetes mellitus. Patients with abnormal heart rate recovery had a higher heart rate at rest than those with normal heart rate recovery (77.5 +/- 13.6 vs. 72.3 +/- 12.5 (bpm), p<0.05). However, no differences in left ventricular geometry investigated with echocardiography were observed between patients with normal and abnormal heart rate recovery. Furthermore, there was no difference in various scintigraphic variables between patients with normal and abnormal heart rate recovery. A stepwise multivariate analysis showed that heart rate at rest and diabetes mellitus were independent predictor of heart rate recovery (p<0.05).
Our results suggested that heart rate recovery is associated with clinical factors related to the cardiac autonomic function such as diabetes mellitus and heart rate at rest, but not with other ones such as left ventricular geometry and myocardial ischemia.
运动后心率恢复是心血管疾病和全因死亡率的独立预后指标。本研究的目的是阐明心率恢复的临床决定因素。
我们连续检查了114例男性患者，这些患者接受了运动心肌灌注单光子发射计算机断层扫描和超声心动图检查，以评估疑似冠状动脉疾病。心率恢复通过运动后恢复第一分钟的心率减去运动时的最大心率来获得。50例患者（43.9%）存在异常心率恢复。心率恢复异常的患者更易患糖尿病。心率恢复异常的患者静息心率高于心率恢复正常的患者（77.5±13.6对72.3±12.5（次/分），p<0.05）。然而，在心率恢复正常和异常的患者之间，未观察到超声心动图所研究的左心室几何结构有差异。此外，心率恢复正常和异常的患者之间在各种闪烁显像变量上也没有差异。逐步多变量分析显示，静息心率和糖尿病是心率恢复的独立预测因素（p<0.05）。
我们的结果表明，心率恢复与糖尿病和静息心率等与心脏自主神经功能相关的临床因素有关，但与左心室几何结构和心肌缺血等其他因素无关。
