Barbosa Lins Tereza Cristina, Valente Lucila Maria, Sobral Filho Dário Celestino, Barbosa e Silva Odwaldo
Departamento de Pós-Graduação em Ciências da Saúde, Universidade Federal de Pernambuco, Recife, Pernambuco, Brasil.
Departamento de Pós-Graduação em Ciências da Saúde, Universidade Federal de Pernambuco, Recife, Pernambuco, Brasil.
Rev Port Cardiol. 2015 Jan;34(1):27-33. doi: 10.1016/j.repc.2014.07.006. Epub 2015 Jan 8.
Impaired heart rate (HR) recovery after exercise testing is considered a predictor of cardiovascular mortality as it reflects vagus nerve dysfunction.
To assess the relationship between body mass index (BMI) and HR recovery after exercise.
We analyzed the records of 2443 patients of both sexes, aged between 20 and 59 years, in sinus rhythm, not using negative chronotropic agents and with no myocardial ischemic response to exercise testing carried out at a specialist clinic, between 2005 and 2011. BMI was categorized as normal (18.5-<25 kg/m(2)), overweight (25-≤30 kg/m(2)) or obese (>30 kg/m(2)). The different BMI groups were compared in terms of HR recovery after exercise, which was calculated as the difference between maximum HR during exercise and in the first minute of recovery. Recovery was considered impaired when the difference was ≤12 bpm.
Eighty-seven (3.6%) patients presented impaired recovery, which was three times more prevalent in the obese group and twice as prevalent in the overweight group compared with the normal group (p<0.001 and p=0.010, respectively). Obese patients presented higher basal HR and lower maximum HR, as well as reduced chronotropic reserve (p<0.001). In multivariate analysis, impaired HR recovery was associated with overweight (relative risk [RR]=1.8; p=0.035), obesity (RR=2; p=0.016), number of metabolic equivalents (RR=0.82; p<0.001) and resting HR (RR=1.05; p<0.001). The hazard ratio for hypertension was 2 (p=0.083, NS).
Impaired HR recovery was associated with higher BMI, demonstrating that obese individuals present vagus nerve dysfunction.
运动试验后心率（HR）恢复受损被认为是心血管死亡率的一个预测指标，因为它反映了迷走神经功能障碍。
评估体重指数（BMI）与运动后心率恢复之间的关系。
我们分析了2005年至2011年间在一家专科诊所进行运动试验的2443例年龄在20至59岁之间、窦性心律、未使用负性变时药物且对运动试验无心肌缺血反应的男女患者的记录。BMI分为正常（18.5-<25kg/m²）、超重（25-≤30kg/m²）或肥胖（>30kg/m²）。比较不同BMI组运动后的心率恢复情况，心率恢复情况通过运动时的最大心率与恢复第一分钟时的心率之差来计算。当差值≤12次/分钟时，恢复被认为受损。
87例（3.6%）患者恢复受损，与正常组相比，肥胖组的发生率是正常组的三倍，超重组的发生率是正常组的两倍（分别为p<0.001和p=0.010）。肥胖患者的基础心率较高，最大心率较低，变时储备也降低（p<0.001）。在多变量分析中，心率恢复受损与超重（相对风险[RR]=1.8；p=0.035）、肥胖（RR=2；p=0.016）、代谢当量数量（RR=0.82；p<0.001）和静息心率（RR=1.05；p<0.001）相关。高血压的风险比为2（p=0.083，无统计学意义）。
心率恢复受损与较高的BMI相关，表明肥胖个体存在迷走神经功能障碍。
