Department of Cardiology, Hacettepe University Faculty of Medicine, Sihhiye/Ankara, Ankara 06100, Turkey.
Europace. 2011 Apr;13(4):526-32. doi: 10.1093/europace/euq410. Epub 2010 Nov 13.
Heart rate (HR) recovery (HRR), defined as the rate of decline in the HR immediately following the cessation of exercise, is influenced by autonomic function. Heart rate recovery in heart failure (HF) has been shown to correlate with severity of HF. Cardiac resynchronization therapy (CRT) improves cardiac autonomic functions in HF. We aimed to evaluate the effects of CRT on cardiac autonomic function assessed by HRR.
Forty-eight patients [62.3 ± 10.7 years; 37 men; left ventricular (LV) ejection fraction 24.8 ± 4.1%] with HF were enrolled. A treadmill exercise testing was conducted in all patients by using a modified Naughton protocol before and 6 months after CRT. Heart rate recovery indices were calculated by subtracting first, second, and third minute HR from the maximal HR and designated as HRR1, HRR2, and HRR3, respectively. Standard echocardiography was performed before and 6 months after CRT. Left ventricular reverse remodelling (LVRM) was quantified as the percentage of decline in the LV end-systolic volume after CRT. Mean HRR1 (13.0 ± 5.9 vs. 17.9 ± 8.9 b.p.m., P = 0.001), HRR2 (20.5 ± 9.3 vs. 23.8 ± 11.3 b.p.m., P = 0.001), and HRR3 (25.7 ± 11.1 vs. 29.2 ± 12.0 b.p.m., P = 0.001) values improved 6 months after CRT. Pearson's analyses revealed a good positive correlation between LVRM and ΔHRR1 (r = 0.642, P = 0.001) and a moderate correlation between reduction LVRM and ΔHRR2 (r = 0.591, P = 0.033) and ΔHRR3 (r = 0.436, P = 0.001).
Cardiac resynchronization therapy favourably alters the cardiac autonomic functions. Heart rate recovery indices improved after CRT and the degree of improvement in HRR indices correlated with LVRM.
心率恢复（HRR）定义为运动停止后心率下降的速度，受自主神经功能的影响。心力衰竭（HF）患者的 HRR 与 HF 的严重程度相关。心脏再同步治疗（CRT）可改善 HF 患者的心脏自主神经功能。我们旨在评估 CRT 对 HRR 评估的心脏自主神经功能的影响。
共纳入 48 例 HF 患者[62.3 ± 10.7 岁；37 名男性；左心室射血分数 24.8 ± 4.1%]。所有患者均采用改良的 Naughton 方案进行跑步机运动试验，在 CRT 前后 6 个月进行。通过从最大 HR 中减去第一、第二和第三分钟 HR 来计算 HRR 指数，并分别指定为 HRR1、HRR2 和 HRR3。在 CRT 前后进行标准超声心动图检查。左心室逆向重构（LVRM）定义为 CRT 后左心室收缩末期容积的下降百分比。CRT 后 6 个月，平均 HRR1（13.0 ± 5.9 与 17.9 ± 8.9 b.p.m.，P = 0.001）、HRR2（20.5 ± 9.3 与 23.8 ± 11.3 b.p.m.，P = 0.001）和 HRR3（25.7 ± 11.1 与 29.2 ± 12.0 b.p.m.，P = 0.001）值均得到改善。Pearson 分析显示 LVRM 与 ΔHRR1 之间存在良好的正相关性（r = 0.642，P = 0.001），LVRM 减少与 ΔHRR2（r = 0.591，P = 0.033）和 ΔHRR3（r = 0.436，P = 0.001）之间存在中度相关性。
心脏再同步治疗可显著改变心脏自主神经功能。CRT 后 HRR 指数改善，HRR 指数的改善程度与 LVRM 相关。
