Exercise heart rate gradient: A novel index to predict all-cause mortality

Background Although substantial evidence relates reduced exercise heart rate (HR) reserve and recovery to a higher risk of all-cause mortality, a combined indicator of these variables has not been explored. Our aim was to combine HR reserve and recovery into a single index and to assess its utility...

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Veröffentlicht in:European journal of preventive cardiology 2015-05, Vol.22 (5), p.629-635
Hauptverfasser: Duarte, Carlos Vieira, Myers, Jonathan, de Araújo, Claudio Gil Soares
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Sprache:eng
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Zusammenfassung:Background Although substantial evidence relates reduced exercise heart rate (HR) reserve and recovery to a higher risk of all-cause mortality, a combined indicator of these variables has not been explored. Our aim was to combine HR reserve and recovery into a single index and to assess its utility to predict all-cause mortality. Design Retrospective cohort analysis. Methods Participants were 1476 subjects (937 males) aged between 41 and 79 years who completed a maximal cycle cardiopulmonary exercise test while not using medication with negative chronotropic effects or having an implantable cardiac pacemaker. HR reserve (HR maximum – HR resting) and recovery (HR maximum – HR at 1-min post exercise) were calculated and divided into quintiles. Quintile rankings were summed yielding an exercise HR gradient (EHRG) ranging from 2 to 10, reflecting the magnitude of on- and off-HR transients to exercise. Survival analyses were undertaken using EHRG scores and HR reserve and recovery in the lowest quintiles (Q1). Results During a mean follow up of 7.3 years, 44 participants died (3.1%). There was an inverse trend for EHRG scores and death rate (p 
ISSN:2047-4873
2047-4881
DOI:10.1177/2047487314520784