Fecchio Rafael Yokoyama, Chehuen Marcel, Peçanha Tiago, Cucato Gabriel Grizzo, Costa Luiz Augusto Riani, Leicht Anthony Scott, Ritti-Dias Raphael Mendes, Wolosker Nelson, Forjaz Cláudia Lúcia de Moraes
School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil.
Albert Einstein Israelite Hospital, São Paulo, Brazil.
Clin Physiol Funct Imaging. 2018 Jul;38(4):603-609. doi: 10.1111/cpf.12452. Epub 2017 Jul 28.
Postexercise heart rate recovery (HRR) is a non-invasive tool for cardiac autonomic function assessment. Reproducibility of HRR has been established in healthy subjects; however, no study has evaluated this reproducibility in clinical populations who may present autonomic dysfunction. Patients with peripheral artery disease and intermittent claudication (IC) often present altered cardiac autonomic function and HRR could be an interesting tool for evaluating autonomic responses to interventions in this population. Therefore, the reproducibility of HRR should be determined in this specific population.
To determine the reproducibility of HRR indices in patients with IC.
Nineteen men with IC underwent two repeated maximal treadmill tests. Raw HR and relative HRR (difference to exercise peak) indices measured at 30, 60, 120, 180, 240 and 300s of recovery were evaluated. The presence of systematic bias was assessed by comparing test and retest mean values via paired t-test. Reliability was assessed by intraclass correlation coefficient (ICC), and agreement by typical error (TE), coefficient of variation (CV) and minimal detectable difference (MDD).
There were no significant differences between the test and retest values of all raw HR and relative HRR indices (P ≥ 0·05), except for HR120s (P = 0·032). All indices exhibited excellent reliability (ICC ≥ 0·78). Raw HR and relative HRR indices showed TEs ≤ 6·4 bpm and MDDs ≤ 17·8 bpm. In addition, all indices showed CVs ≤ 13·2%, except HRR30s (CV = 45·6%).
The current results demonstrated that most HRR indices were highly reproducible with no systematic error, excellent reliability and good agreement in patients with IC following maximal graded exercise.
运动后心率恢复（HRR）是评估心脏自主神经功能的一种非侵入性工具。HRR在健康受试者中的可重复性已得到证实；然而，尚无研究评估其在可能存在自主神经功能障碍的临床人群中的可重复性。外周动脉疾病和间歇性跛行（IC）患者常出现心脏自主神经功能改变，HRR可能是评估该人群对干预措施自主神经反应的一个有趣工具。因此，应在这一特定人群中确定HRR的可重复性。
确定IC患者HRR指标的可重复性。
19名IC男性患者进行了两次重复的最大运动平板试验。评估了恢复30、60、120、180、240和300秒时测量的原始心率和相对HRR（与运动峰值的差值）指标。通过配对t检验比较测试值和复测值来评估系统偏差的存在。通过组内相关系数（ICC）评估可靠性，通过典型误差（TE）、变异系数（CV）和最小可检测差异（MDD）评估一致性。
除HR120s（P = 0.032）外，所有原始心率和相对HRR指标的测试值和复测值之间均无显著差异（P≥0.05）。所有指标均表现出极好的可靠性（ICC≥0.78）。原始心率和相对HRR指标的TE≤6.4次/分钟，MDD≤17.8次/分钟。此外，除HRR30s（CV = 45.6%）外，所有指标的CV≤13.2%。
目前的结果表明，在最大分级运动后的IC患者中，大多数HRR指标具有高度可重复性，无系统误差，可靠性极佳，一致性良好。
