Impaired heart rate recovery may predict radial artery spasm in patients undergoing coronary angiography via radial access

2021 ◽  
Author(s):  
İsmail Gürbak ◽  
Arda Güler ◽  
Cafer Panç ◽  
Ahmet Güner ◽  
Mehmet Ertürk
Keyword(s):  
Heart Rate ◽  
Coronary Angiography ◽  
Radial Artery ◽  
Autonomic Dysfunction ◽  
Heart Rate Recovery ◽  
Stress Test ◽  
Female Gender ◽  
Current Data ◽  
Autonomic Nervous System Dysfunction ◽  
Procedural Time

Objectives: Radial artery spasm (RAS) is associated with several pathophysiological pathways, including endothelial and autonomic dysfunction, and causes failed coronary interventions. Heart rate recovery (HRR) is a simple measurement of autonomic nervous system dysfunction. We aimed to investigate the relationship between HRR and RAS during coronary angiography (CA) in the present study. Patients and Methods: This study included 167 patients (mean age 54.6 ± 8.2, 131 males) who underwent a treadmill stress test (TST) according to the Bruce protocol before trans-radial CA. HRR in the first minute (HRR1) was calculated as the difference between peak heart rate and heart rate one minute after the TST. Patients were divided into two groups according to the presence of RAS. Results: Among the study population, RAS developed in 26 patients (15.5%). HRR1 and HRR in the third minute (HRR3) were lower in the RAS group. Also, the abnormal HRR1 rate was higher in the RAS group (35.5% vs. 76.9%, p < 0.001). Total procedural time, more than one puncture attempt, more than one catheter use, fluoroscopy time, radiation exposure, contrast volume was higher in the RAS group. Female gender, total procedural time, more than one catheter use, and abnormal HRR1 were independent predictors of RAS. Conclusion: The current data suggest that a significant relationship was found between abnormal HRR1 and RAS. HRR, a simple autonomic dysfunction parameter, can provide additional information regarding the success of radial procedures.

scholarly journals Heart rate recovery in patients with ischemic heart disease - risk factors

2014 ◽  
Vol 87 (4) ◽  
pp. 220-225 ◽  
Author(s):  
Cosmin Grad ◽  
Dumitru Zdrenghea
Keyword(s):  
Risk Factors ◽  
Heart Rate ◽  
Nervous System ◽  
Multivariate Analysis ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Heart Rate Recovery ◽  
Stress Test ◽  
Ischemic Heart ◽  
Central Nervous System Dysfunction

Background and aim. Central nervous system dysfunction is associated with mortality and morbidity in patients with cardiovascular disease, post-workout recovery and faster heart rate being mediated by the dynamic interaction between the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS), as components of the autonomic nervous system. Heart rate recovery is the decline in heart rate after exercise. The aim of the study was to determine the influence of certain clinical and paraclinical parameters on heart rate recovery after exercise in patients with ischemic heart disease. Methods. The study included 260 patients who were subjected to cardiovascular stress test. The following parameters were measured in each patient: blood pressure and pulse rate prior to exercise, during exercise and at protocol-established time intervals, as well as 1 and 3 minutes after the end of the stress test. Statistical analysis was performed usingMedCalc software version 14.8.1 Results. Elderly patients had slower heart rate recovery at 1 minute after effort. Female patients have recovered significantly better the heart rate, at 1 minute and 3 minutes after effort compared to the males. This difference was maintained in multivariate analysis, independent of age or comorbidities of patients. The presence of ischemic heart disease was the most important factor independently associated with HRR1.Triglyceride values were negatively correlated with both HRR3 and HRR1 and independent of other factors present in the multivariate analysis. Conclusions. Autonomic dysfunction is involved in the development of cardiovascular risk factors like hypertension, diabetes, dyslipidemia and was directly correlated with morbidity and mortality caused by coronary heart disease.

scholarly journals Age influence on the magnitude of heart rate recovery in trained athletes

2020 ◽  
Vol 19 (6) ◽  
pp. 450
Author(s):  
Victor Tavares De Santana ◽  
Herón Rached ◽  
Iago Nunes Aguillar ◽  
Giulliano Gardenghi ◽  
Débora Dias Ferraretto Moura Rocco ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Recovery ◽  
Stress Test ◽  
Initial Period ◽  
Soccer Players ◽  
Slow Phase ◽  
Physical Conditioning ◽  
Fitness Level ◽  
Fast Phase ◽  
Effect Of Age

Introduction: Heart rate recovery (HRR), defined as a decline in heart rate (HR) after exercise, is controlled by neurohumoral factors. There are two observed phases of HRR, the fast (vagal reactivation), which comprises the initial period between 60 and 120 seconds and the slow (sympathetic withdrawal), which goes until the return to rest values. Several factors may influence HRR, such as fitness level, gender, age and others. Objective: To test the hypothesis that there is a difference in the decline in HRR between trained adults and teenagers. Methods: 58 male soccer players were evaluated, divided into two groups: Teenagers (TG) and Adults (AG) aged 16.4 ± 0.5 and 27.9 ± 0.9 years, respectively. Anthropometric, HR and blood pressure (BP) analyzes were performed. Results: Both groups reached and exceeded the maximum heart rate (HRmax) predicted by age. The observed values were similar at the end of the HRR fast phase, while at the end of the slow phase the TG group obtained significantly higher values. Values of P<0.05 were considered significant. Conclusion: The results of the fast phase show that high levels of physical conditioning seem to attenuate the deleterious effect of age on vagal reactivation. The same effect was not observed on the sympathetic withdrawal during the slow phase; therefore, the TG group obtained higher HRR values during this period.Keywords: autonomic nervous system, stress test, heart rate, adult, teenagers.

scholarly journals The prognostic role of heart rate recovery after exercise and metabolic syndrome in IgA nephropathy

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Balázs Sági ◽  
István Késői ◽  
Tibor Vas ◽  
Botond Csiky ◽  
Judit Nagy ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Heart Rate ◽  
Iga Nephropathy ◽  
Heart Rate Recovery ◽  
Stress Test ◽  
Prognostic Role ◽  
Cox Regression Analysis ◽  
Ckd Stage ◽  
Significant Difference

Abstract Background Cardiovascular (CV) morbidity and mortality are higher in chronic kidney disease (CKD) than in the general population. Reduced heart rate recovery (HRR) is an independent risk factor for CV disease. The aim of the study was to determine the prognostic role of HRR in a homogenous group of CKD patients. Methods One hundred and twenty-five IgA nephropathy patients (82 male, 43 female, age 54.7 ± 13 years) with CKD stage 1–4 were investigated and followed for average 70 months. We performed a graded exercise treadmill stress test. HRR was derived from the difference of the peak heart rate and the heart rate at 1 min after exercise. Patients were divided into two groups by the mean HRR value (22.9 beats/min). The composite (CV and renal) endpoints included all-cause mortality and any CV event such as stroke, myocardial infarction, revascularisation (CV) and end-stage renal disease, renal replacement therapy (renal). Results Patients with reduced HRR (< 23 bpm) had significantly more end point events (22/62 patients vs. 9/53 patients, p = 0.013) compared to the higher HRR (≥23 bpm). Of the secondary the endpoints (CV or renal separately) rate of the renal endpoint was significantly higher in the lower HRR group (p = 0.029), while there was no significant difference in the CV endpoint between the two HRR groups (p = 0.285). Independent predictors of survival were eGFR and diabetes mellitus by using Cox regression analysis. Kaplan-Meier curves showed significant differences in metabolic syndrome and non-metabolic syndrome when examined at the combined endpoints (cardiovascular and renal) or at each endpoint separately. The primary endpoint rate was increased significantly with the increased number of metabolic syndrome component (Met.sy. comp. 0 vs. Met. sy. comp. 2+, primary endpoints, p = 0.012). Conclusion Our results showed that reduced HRR measured by treadmill exercise test has a predictive value for the prognosis of IgA nephropathy. The presence of metabolic syndrome may worsen the prognosis of IgA nephropathy.

PS 17-11 DELAYED HEART RATE RECOVERY IS ASSOCIATED WITH DELAYED HYPERTENSIVE RESPONSE DURING RECOVERY STAGE OF EXERCISE STRESS TEST IN NON-HYPERTENSIVES

2016 ◽  
Vol 34 (Supplement 1) ◽  
pp. e476-e477
Author(s):  
Se-Jung Yoon ◽  
Sanghoon Shin ◽  
Jong-Kwan Park ◽  
Seungjin Oh ◽  
Dong Woon Jeon ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Recovery ◽  
Stress Test ◽  
Exercise Stress Test ◽  
Exercise Stress ◽  
Recovery Stage

Post-exercise heart rate recovery and its speed are associated with cardiac autonomic responsiveness following orthostatic stress test in men

2021 ◽  
pp. 1-13
Author(s):  
Guilherme E. Molina ◽  
Carlos J. G. da Cruz ◽  
Keila E. Fontana ◽  
Edgard M. K. V. K. Soares ◽  
Luiz Guilherme G. Porto ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Recovery ◽  
Stress Test ◽  
Exercise Heart Rate ◽  
Orthostatic Stress ◽  
Post Exercise ◽  
Orthostatic Stress Test

scholarly journals Impact of Opioid Analgesia and Inhalation Sedation Kalinox on Pain and Radial Artery Spasm during Transradial Coronary Angiography

2020 ◽  
Vol 9 (9) ◽  
pp. 2747
Author(s):  
Caroline Birgy ◽  
Antonin Trimaille ◽  
Nathan Messas ◽  
Jessica Ristorto ◽  
Anas Kayali ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Radial Artery ◽  
Female Gender ◽  
Pain Scale ◽  
Bleeding Events ◽  
Transfemoral Approach ◽  
Inhalation Sedation ◽  
Primary Endpoints ◽  
Nitrous Oxide Oxygen ◽  
Reduction Of Mortality

With respect to the transfemoral approach, transradial procedures enable a drastic reduction of bleeding events and are associated with a reduction of mortality. Radial artery spasm (RAS) is one of the most common complications and may lead to patient discomfort and procedural failure. Currently, there is no consensus on the optimal sedation protocol to avoid RAS. The aim of this study was to investigate the respective impact of opioids analgesia and inhalation sedation with a 50% nitrous oxide/oxygen premix (Kalinox) on pain and occurrence of RAS during transradial coronary procedures. Consecutive patients undergoing transradial coronary angiography were prospectively enrolled in one, single center observational study (Nouvel Hôpital Civil, Strasbourg, France). Patients received opioids analgesia or inhalation sedation with Kalinox. The primary endpoints of the study were the incidence of a pain scale ≥5/10 and the occurrence of RAS. The secondary endpoints were the incidence of side effects. A total of 325 patients were enrolled (185 in the opioids analgesia group, 140 in the Kalinox group). RAS and pain scale ≥5 rates were not significantly different in the opioids analgesia and Kalinox groups (respectively 13.5% vs. 10.0% and 16.2% vs. 11.4%). Headache was more frequently observed in the Kalinox group (6.4% vs. 0.0%; p = 0.002). By multivariate analysis, female gender, BMI <25 kg/m2, puncture difficulty, the use of plastic needle and 6F sheath were identified as independent predictors of RAS. Procedural inhalation sedation by Kalinox is as safe as opioids analgesia during transradial coronary angiography.

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