Liontou Catherine, Chrysohoou Christina, Skoumas John, Panagiotakos Demosthenes B, Pitsavos Christos, Stefanadis Christodoulos
First Department of Cardiology, Hippokration Hospital, School of Medicine, University of Athens, 114 Vasilissis Sofias Street, 115 27, Athens, Greece.
Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
Heart Vessels. 2016 Feb;31(2):129-36. doi: 10.1007/s00380-014-0584-6. Epub 2014 Sep 25.
Carotid atherosclerosis (CA) and chronotropic incompetence (CI) during exercise are two independent cardiovascular risk factors. Aim of the current study was to investigate the possible association between them, in apparently healthy individuals, after adjusting for the 10-year cardiovascular disease (CVD) risk score. This cross-sectional study consisted of 139 apparently healthy subjects, 40-65 years old, who underwent treadmill exercise test (Bruce protocol used), which showed no evidence of ischemia. Heart rate reserve (HR reserve) was calculated to assess chronotropic response; a value of ≤ 0.80 is considered CI. CA was assessed by the presence of carotid plaque(s) in common and internal carotid arteries and carotid bulb bilaterally, using B-mode ultrasound. A calibrated version of SCORE (i.e., HellenicSCORE) was used to estimate the 10-year fatal CVD risk; participants were classified into low-, moderate- or high-risk group. CI was present in 7.9 % and CA in 18.7 % of the participants. After adjusting for 10-year CVD risk and other key confounders, odds of CA were 8.6 times higher in subjects with CI compared to their counterparts with normal chronotropic response to exercise. The results of the study indicate that CI during exercise can lead to high clinical suspicion of CA in apparently healthy individuals.
颈动脉粥样硬化（CA）和运动时变时性功能不全（CI）是两个独立的心血管危险因素。本研究的目的是在调整10年心血管疾病（CVD）风险评分后，调查明显健康个体中它们之间可能存在的关联。这项横断面研究包括139名40 - 65岁的明显健康受试者，他们接受了跑步机运动试验（采用布鲁斯方案），试验未显示缺血迹象。计算心率储备（HR储备）以评估变时反应；≤0.80的值被认为是CI。使用B型超声通过双侧颈总动脉、颈内动脉和颈动脉球部是否存在颈动脉斑块来评估CA。使用校准版的SCORE（即希腊SCORE）来估计10年致命性CVD风险；参与者被分为低、中或高风险组。7.9%的参与者存在CI，18.7%的参与者存在CA。在调整10年CVD风险和其他关键混杂因素后，与运动时变时反应正常的受试者相比，存在CI的受试者患CA的几率高出8.6倍。研究结果表明，运动时的CI会导致对明显健康个体高度怀疑患有CA。
