scholarly journals Deterioration of heart rate recovery index in patients after carotid artery stenting

2017 ◽  
Vol 23 (6) ◽  
pp. 578-582
Author(s):  
Emrah Aytac ◽  
Murat Gonen ◽  
Orhan Dogdu ◽  
Mehmet Balin
Keyword(s):  
Heart Rate ◽  
Carotid Artery ◽  
Exercise Testing ◽  
Carotid Artery Stenting ◽  
Heart Rate Recovery ◽  
Recovery Period ◽  
Exercise Stress ◽  
Peak Exercise ◽  
Maximal Heart Rate ◽  
Metabolic Equivalents

Objective Although carotid artery stenting (CAS) is an effective treatment for severe carotid stenosis, it has been associated with alterations in autonomic functions long term after the procedure. Patients with CAS have been reported to have autonomic nervous system (ANS) dysfunction. This study aimed to evaluate heart rate recovery (HRR) indices and exercise test parameters after CAS. Methods Patients (10 male, 11 female) suitable for CAS, without a history of hypertension, diabetes mellitus, severe coronary artery or valvular heart disease, were enrolled in our study. Basal electrocardiography, echocardiography, and treadmill exercise testing were performed in all patients pre- and post-procedure. The HRR index was defined as the reduction in the heart rate from the rate at peak exercise to the rate first minute (HRR1), second minute (HRR2), third minute (HRR3) and fifth minute (HRR5) after the cessation of exercise stress testing. Results The exercise time, maximal heart rate, maximal blood pressure and maximal metabolic equivalents values were significantly decreased after the procedure. The first- and second-minute HRR indices of patients before procedure were significantly lower than after procedure (23.5 ± 6.6 vs 25.8 ± 8.3; p < 0.001 and 41.8 ± 12.3 vs 50.2 ± 16.3; p < 0.001, respectively). Similarly, HRR indices after the third and fifth minutes of the recovery period were significantly lower in patients before procedure, when compared with those indices after procedure (52.9 ± 13.1 vs 60.7 ± 14.4; p < 0.001 and 62.4 ± 12.8 vs 71.9 ± 14.1; p < 0.001). Conclusion We have demonstrated that HRR indices increased in the first, second, third and fifth minutes of the recovery period after maximal exercise testing in patients after the CAS procedure, which may be a reflection of parasympathetic dominance after CAS.

Deterioration of Heart Rate Recovery Index in Patients with Systemic Lupus Erythematosus

2010 ◽  
Vol 37 (12) ◽  
pp. 2511-2515 ◽  
Author(s):  
ORHAN DOGDU ◽  
MIKAIL YARLIOGLUES ◽  
MEHMET GUNGOR KAYA ◽  
IDRIS ARDIC ◽  
NILUFER OGUZHAN ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Heart Rate ◽  
Lupus Erythematosus ◽  
Heart Rate Recovery ◽  
Recovery Period ◽  
Exercise Stress ◽  
Control Group ◽  
Systemic Lupus ◽  
Metabolic Equivalents ◽  
Recovery Index

Objective.Systemic lupus erythematosus (SLE) is an autoimmune disorder resulting in multisystemic inflammatory damage. It is reported that cardiovascular diseases (CVD) are responsible for 20%–30% of deaths in patients with SLE. Heart rate recovery after exercise is a function of vagal reactivation, and its impairment is an independent prognostic indicator for cardiovascular and all-cause mortality. The aim of our study was to evaluate the heart rate recovery index in patients with SLE.Methods.The study population included 48 patients with SLE (35 women, mean age 46.3 ± 12.8 yrs, mean disease duration 6.0 ± 2.3 yrs) and 44 healthy controls (30 women, mean age 45.7 ± 12.9 yrs). Basal electrocardiography, echocardiography, and treadmill exercise testing were performed on all patients and controls. The heart rate recovery index was defined as the reduction in the heart rate from the rate at peak exercise to the rate at the first minute (HRR1), second minute (HRR2), third minute (HRR3), and fifth minute (HRR5) after stopping exercise stress testing.Results.There were significant differences in HRR1 and HRR2 indices between patients with SLE and the control group (24.1 ± 6.5 vs 33.3 ± 9.3; p < 0.001, and 44.6 ± 13.3 vs 53.7 ± 9.9; p < 0.001, respectively). Similarly, HRR3 and HRR5 indices of the recovery period were lower in patients with SLE, compared with indices in the control group (57.6 ± 13.0 vs 64.9 ± 11.7; p = 0.006, and 67.2 ± 12.3 vs 75.0 ± 15.4; p = 0.009, respectively). Effort capacity was markedly lower (9.0 ± 1.9 vs 11.1 ± 2.3 metabolic equivalents; p = 0.001, respectively) among the patients with SLE.Conclusion.The heart rate recovery index is deteriorated in patients with SLE. When the prognostic significance of the heart rate recovery index is considered, these results may contribute to explain the increased occurrence of cardiac death. It points to the importance of the heart rate recovery index in the identification of high-risk patients.

Obesity Modifies the Effect of Fitness on Heart Rate Indices during Exercise Stress Testing in Asymptomatic Individuals

Cardiology ◽  
2015 ◽  
Vol 132 (4) ◽  
pp. 242-248
Author(s):  
Ehimen C. Aneni ◽  
Ebenezer T. Oni ◽  
Chukwuemeka U. Osondu ◽  
Seth S. Martin ◽  
Michael J. Blaha ◽  
...  
Keyword(s):  
Heart Rate ◽  
Stress Test ◽  
Statistical Significance ◽  
Normal Weight ◽  
Exercise Stress ◽  
Peak Exercise ◽  
Exercise Heart Rate ◽  
Cross Sectional ◽  
Metabolic Equivalents ◽  
The Impact

Objective: To assess the impact of aerobic fitness on exercise heart rate (HR) indices in an asymptomatic cohort across different body mass index (BMI) categories. Methods: We performed a cross-sectional analysis of 506 working-class Brazilian subjects, free of known clinical cardiovascular disease (e.g. ischemic heart disease and stroke) who underwent an exercise stress test. Results: There was a significant trend towards decreased HR at peak exercise, HR recovery and chronotropic index (CI) measures as BMI increased, but resting HR increased significantly across BMI categories. In multivariate analysis, the change in CI per unit change in metabolic equivalents of task was greater among the obese subjects than the normal-weight (2.7 vs. -0.07; p interaction = 0.029) and overweight (2.7 vs. 0.7; p interaction = 0.044) subjects. A similar pattern was seen with peak HR and HR recovery, although the formal tests of interaction did not achieve statistical significance. Conclusion: Our findings strongly suggest that fitness is associated with a favorable HR profile and is modified by BMI. Intervention programs should place emphasis on fitness and not only on weight loss.

scholarly journals Relationship between adiposity and heart rate recovery following an exercise stress test in obese older women

2017 ◽  
Vol 19 (5) ◽  
pp. 554 ◽  
Author(s):  
Cristiane Rocha da Silva ◽  
Dahan Cunha Nascimento ◽  
Luana Claudia Dias Bicalho ◽  
Ramires Alsamir Tibana ◽  
Bruno Saraiva ◽  
...  
Keyword(s):  
Heart Rate ◽  
Older Women ◽  
Body Fat ◽  
Heart Rate Recovery ◽  
Stress Test ◽  
Recovery Period ◽  
Exercise Stress Test ◽  
Exercise Stress ◽  
Percent Body Fat ◽  
Obese Women

The aim of the present study was to compare differences in heart rate (HR) response during and following exercise in obese older women with different percent body fat levels. Ninety older, obese women aged 60-87 years participated in the study, were categorized, and enrolled to one of two groups based on a lower percent body fat (LPBF ≤ 41.10 %) or higher percent body fat (HPBF > 41.10 %) as measured by dual-energy x-ray absorptiometry. The peak HR during exercise and in the first and second minutes of recovery period were compared between groups. The HPBF group presented a lower peak HR during exercise (p = 0.001) and an impaired HR recovery (p = 0.001) when compared to LPBF group. The present study demonstrated that older women who were in exceedingly obese level have an impaired heart rate response during exercise and in the recovery period, indicating possible autonomic dysfunction.

Blunted Heart Rate Recovery to Spontaneous Nocturnal Arousals in Short Sleeping Adults

2021 ◽  
Author(s):  
Jeremy A. Bigalke ◽  
Ian M. Greenlund ◽  
Jennifer R. Nicevski ◽  
Carl A. Smoot ◽  
Benjamin Oosterhoff ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Recovery ◽  
Recovery Period ◽  
Sleep Time ◽  
Cardiovascular Complications ◽  
Female Age ◽  
Cardiac Reactivity ◽  
Electrocardiogram Ecg ◽  
The Relationship ◽  
At Home

Chronic insufficient sleep is a common occurrence around the world, and results in numerous physiological detriments and consequences, including cardiovascular complications. The purpose of the present study was to assess the relationship between habitual total sleep time (TST) measured objectively via at-home actigraphy and heart rate (HR) reactivity to nocturnal cortical arousals. We hypothesized that short habitual TST would be associated with exaggerated cardiac reactivity to nocturnal cortical arousals. Participants included in 35 healthy individuals (20 male, 15 female, age: 24 ± 1, BMI: 27 ± 1 kg/m2), and were split using a median analysis into short (SS; n = 17) and normal sleeping (NS; n = 18) adults based on a minimum of 7 days of at-home actigraphy testing. All participants underwent a full overnight laboratory polysomnography (PSG) testing session, including continuous HR (electrocardiogram, ECG) sampling. HR reactivities to all spontaneous cortical arousals were assessed for 20 cardiac cycles following the onset of the arousal in all participants. Baseline HR was not significantly different between groups (P > .05). Spontaneous nocturnal arousal elicited an augmented HR response in the SS group, specifically during the recovery period [F (4.192, 134.134) = 3.413, p = .01]. There were no significant differences in HR reactivity between sexes [F (4.006, 128.189) = .429, p > .05]. These findings offer evidence of nocturnal cardiovascular dysregulation in habitual short sleepers, independent from any diagnosed sleep disorders.

scholarly journals Autonomic cardiovascular response during and after a graded exercise test in concussed athletes and healthy controls

2021 ◽  
Vol 5 ◽  
pp. 205970022110448
Author(s):  
Alessandra Ventura ◽  
Fausto Romano ◽  
Mario Bizzini ◽  
Antonella Palla ◽  
Nina Feddermann
Keyword(s):  
Heart Rate ◽  
Cardiovascular System ◽  
Exercise Test ◽  
Cardiovascular Response ◽  
Heart Rate Recovery ◽  
Exercise Intolerance ◽  
Maximal Heart Rate ◽  
Healthy Controls ◽  
Graded Exercise Test ◽  
Graded Exercise

Objective Dysfunction of the autonomic cardiovascular system after a concussion is known to cause exercise intolerance due to symptoms exacerbation. The aim of this study was to compare athletes with symptoms of a sport-related concussion and healthy controls with regard to their heart rate during a graded exercise test and their heart rate recovery during the 5 min cool-down after the graded exercise test. Methods Sport-related concussion patients ( N = 61; 31% female) and controls ( N = 16; 50% female) participated in a graded exercise test on a cycle ergometer followed by 5 min active cool-down. Based on the results of graded exercise tests they were divided into four groups: (1) patients who reached the symptom threshold and had to stop the graded exercise test (symptom threshold; N = 39; 33.3% female), (2) patients with symptoms who finished the graded exercise test (S; N = 16; 25% female), (3) patients without symptoms (NS; N = 6; 33.3% female), (4) controls ( N = 16; 50% female). Main outcome measures Heart rate, severity of headache and dizziness during graded exercise test, heart rate recovery (median (heart rate recoveries/maximal heart rate) ± median absolute deviation (MAD)) 30, 60 and 300 s after the start of cool-down. Results Heart rate recovery at 30 s was significantly slower in symptom (0.95 ± 0.01) compared to all other groups ( p < 0.002; symptom threshold: 0.92 ± 0.02, NS: 0.91 ± 0.02, controls: 0.93 ± 0.02). Heart rate recovery at 60 s was significantly slower in symptom (0.90 ± 0.02) compared to the symptom threshold and controls ( p < 0.041; 0.86 ± 0.03, 0.85 ± 0.04). Heart rate recovery at 300 s was significantly slower in symptom threshold (0.72 ± 0.05) compared to controls ( p = 0.003; 0.66 ± 0.02). Conclusions Heart rate measurements in athletes with symptoms of sport-related concussion should be continued during cool-down after the graded exercise test, as dysfunction of the autonomic cardiovascular system might manifest also during cool-down.

The Clinical Use of Nonimaging Exercise Stress Testing

2019 ◽  
Author(s):  
Aswini Kumar ◽  
Brinda Muthuswamy ◽  
W Lane Duvall ◽  
Paul D Thompson
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Stress Testing ◽  
Blood Pressure Response ◽  
Heart Rate Recovery ◽  
Exercise Stress ◽  
Exercise Stress Testing ◽  
Duke Treadmill Score ◽  
Test Exercise ◽  
Artery Disease

Exercise stress testing is an exceptionally useful cardiovascular test providing a wealth of information that can be used in patient management. It can be used in the diagnosis and/or management of chest pain, hypertension, arrhythmia, and heart failure.  Non-imaging exercise stress testing not only helps evaluate the etiology of clinical symptoms but also provides an opportunity to evaluate ECG changes with exercise, total exercise capacity, heart rate response or chronotropic index, blood pressure response, heart rate recovery, and to make estimates of the risk of coronary artery disease using tools such as the Duke Treadmill Score.  These parameters, individually and collectively, provide valuable information on the likelihood of disease and an individual’s prognosis. In addition, exercise testing is inexpensive, quick and widely available compared to imaging studies.  This review contains 6 figures, 5 tables, and 68 references.  Keywords: blood pressure response, chronotropic incompetence, coronary artery disease, Duke Treadmill Score, exercise physiology metabolic equivalents (METs), exercise stress test, exercise treadmill test, exercise-induced hypertension, heart rate recovery, maximal exercise capacity, ST-segment deviation

Heart Rate Recovery Following Exercise Testing in Pediatric Patients with Acyanotic Repaired Congenital Heart Disease

2022 ◽  
Author(s):  
Natalie S. Shwaish ◽  
Lindsey Malloy-Walton ◽  
Keith Feldman ◽  
Kelli M. Teson ◽  
Jessica S. Watson ◽  
...  
Keyword(s):  
Heart Rate ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Exercise Testing ◽  
Congenital Heart ◽  
Pediatric Patients ◽  
Heart Rate Recovery

Simple heart rate and QT parameters during stress exercise testing to assess presence and severity of stable coronary artery disease

2021 ◽  
Author(s):  
Murugaiyan Rajarajan ◽  
Mugula Sudhakar Rao ◽  
Padmakumar Ramachandran ◽  
Ashwal A Jayaram
Keyword(s):  
Coronary Artery Disease ◽  
Heart Rate ◽  
Coronary Artery ◽  
Heart Rate Recovery ◽  
Stable Coronary Artery Disease ◽  
Peak Exercise ◽  
P Value ◽  
Characteristic Analysis ◽  
Qt Variability ◽  
Artery Disease

Aim: The relationship between QT prolongation and myocardial ischemia is well known, however not many studies have correlated corrected QT interval and heart rate recovery with the severity of coronary artery disease (CAD). Methods: This was a single-center, prospective, observational study which included 127 patients with CAD and 124 patients without CAD. Results: Corrected QT variability from peak to recovery correlated well with CAD with a p value of 0.03. Receiver operative characteristic analysis did not show any significant diagnostic accuracy with any heart rate or QT parameters for predicting the presence or severity of CAD. Conclusion: Coronary artery disease is predicted by reduced ability of the heart rate to rise from rest to peak exercise and reduced recovery of heart rate and corrected QT from peak exercise to recovery at 1 min.

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