Yilmaz Ahmet, Erdem Alim, Kucukdurmaz Zekeriya, Karapinar Hekim, Gul Ibrahim, Sarikaya Savas, Dizman Rafet
Department of Cardiology, Cumhuriyet University Medical School, Sivas, Turkey.
Pacing Clin Electrophysiol. 2013 May;36(5):591-5. doi: 10.1111/pace.12088. Epub 2013 Jan 28.
Heart rate decrease after exercise, that is associated with reactivation of parasympathetic system, is important, as it is also associated with mortality. Previous studies have shown that this is an independent mortality predictor in patients having no coronary artery disease and having normal left ventricular function. In our study, we aimed to study heart rate recovery (HRR) after exercise in patients having impaired left ventricular function.
One hundred and two consecutive patients (68 males, 34 females) requested to perform an exercise stress test were included in our study. Patients were divided into two groups as those having a normal heart rate reserve (Group1, n = 72) and those having an abnormal heart rate reserve (Group2, n = 30).
In Group1 and Group2, resting heart rate averages were found to be 83.61 ± 18.01/min and 85.10 ± 13.40/min, respectively (P > 0.05), and maximum heart rates during exercise were 141.42 ± 19.70/min and 121.17 ± 19.01/min while those in Group1 had statistically significantly higher heart rates (P < 0.001). A statistically significant positive association was found in the correlation test carried out between the maximum heart rate during the treadmill exercise test and ejection fraction (EF) value (r = 0.201; P < 0.05). Metabolic equivalents of task values obtained during the treadmill exercise test in Group1 and Group2 were 9.48 ± 2.28 and 8.36 ± 2.50, respectively, and the difference between the said values was statistically significant (P < 0.05).
We believe that the association between low EF and abnormal HRR is worth studying and randomized large-scale studies are needed to determine mortality risk.
运动后心率下降与副交感神经系统的重新激活有关，这一点很重要，因为它也与死亡率相关。先前的研究表明，在没有冠状动脉疾病且左心室功能正常的患者中，这是一个独立的死亡率预测指标。在我们的研究中，我们旨在研究左心室功能受损患者运动后的心率恢复（HRR）情况。
我们的研究纳入了102例连续要求进行运动负荷试验的患者（68例男性，34例女性）。患者被分为两组，即心率储备正常的患者（第1组，n = 72）和心率储备异常的患者（第2组，n = 30）。
在第1组和第2组中，静息心率平均值分别为83.61±18.01次/分钟和85.10±13.40次/分钟（P>0.05），运动期间的最大心率分别为141.42±19.70次/分钟和121.17±19.01次/分钟，第1组的心率在统计学上显著更高（P<0.001）。在跑步机运动试验期间的最大心率与射血分数（EF）值之间进行的相关性测试中发现了统计学上显著的正相关（r = 0.201；P<0.05）。第1组和第2组在跑步机运动试验期间获得的代谢当量值分别为9.48±±2.28和8.36±2.50，上述值之间的差异具有统计学意义（P<0.05）。
我们认为低EF与异常HRR之间的关联值得研究，需要进行随机大规模研究以确定死亡风险。
