Kuopio Research Institute of Exercise Medicine, Kuopio University HospitalInformation Technology Center, Rovaniemi, Finland.
J Intern Med. 2011 Dec;270(6):589-96. doi: 10.1111/j.1365-2796.2011.02434.x. Epub 2011 Aug 25.
A slow heart rate recovery (HRR) after an exercise test is associated with an increased risk of all-cause mortality in asymptomatic individuals, but the data regarding additional prognostic information provided by HRR beyond other exercise test variables are inconsistent. We investigated the prognostic significance of HRR for premature death, particularly in relation to other exercise test variables.
The study subjects were a representative population-based sample of 1102 men (42-61 years of age) without cardiovascular disease, cancer or diabetes. HRR was defined as the difference between maximal HR and HR 2 min after a maximal symptom-limited exercise test using a cycle ergometer. The association between HRR and premature mortality was examined with Cox regression models.
During an average follow-up of 18 years, 238 deaths occurred. HRR was an independent predictor of death [for a decrease of 12 beats min(-1) , relative risk (RR) 1.16, 95% CI 1.02-1.33, P = 0.02] after adjustment for age and established risk factors. When added in a Cox model with chronotropic response (decrease of 12 beats min(-1) , RR 1.09, 95% CI 0.93-1.27, P = 0.26) or cardiorespiratory fitness (decrease of 12 beats min(-1) , RR 1.12, 95% CI 0.98-1.30, P = 0.08), the association between a slow HRR and an increased risk of death was clearly weaker.
A slow 2-min HRR after a cycle ergometer exercise test was an independent predictor of death in healthy middle-aged men after accounting for demographic and clinical characteristics. However, it was no longer predictive after accounting for chronotropic response and exercise capacity.
在无症状个体中，运动试验后心率恢复（HRR）较慢与全因死亡率增加相关，但关于 HRR 提供的除其他运动试验变量以外的额外预后信息的数据并不一致。我们研究了 HRR 对过早死亡的预测意义，特别是与其他运动试验变量的关系。
研究对象为 1102 名无心血管疾病、癌症或糖尿病的代表性基于人群的男性样本（42-61 岁）。HRR 定义为使用测功计进行最大症状限制运动试验后最大 HR 与 2 分钟后 HR 之间的差异。使用 Cox 回归模型检查 HRR 与过早死亡之间的关联。
在平均 18 年的随访期间，有 238 人死亡。调整年龄和已确立的危险因素后，HRR 是死亡的独立预测因子[每下降 12 次/分钟，相对风险（RR）为 1.16，95%置信区间（CI）为 1.02-1.33，P=0.02]。当在包含变时反应（下降 12 次/分钟，RR 为 1.09，95%CI 为 0.93-1.27，P=0.26）或心肺适应度（下降 12 次/分钟，RR 为 1.12，95%CI 为 0.98-1.30，P=0.08）的 Cox 模型中加入时，HRR 较慢与死亡风险增加之间的关联明显减弱。
在考虑人口统计学和临床特征后，测功计运动试验后 2 分钟 HRR 较慢是健康中年男性死亡的独立预测因子。但是，在考虑变时反应和运动能力后，它不再具有预测性。
