Abnormal heart rate recovery immediately after treadmill testing: Correlation with clinical, exercise testing, and myocardial perfusion parameters
The increase in heart rate during exercise is considered to be attributed to sympathetic system activation combined with parasympathetic withdrawal. The prognostic importance of the chronotropic response to exercise and heart rate recovery 1 minute after exercise has already been established. The pu...
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| Veröffentlicht in: | Journal of nuclear cardiology 2003-09, Vol.10 (5), p.498-505 |
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| creator | Georgoulias, Panagiotis Orfanakis, Alexandros Demakopoulos, Nikolaos Xaplanteris, Petros Mortzos, Georgios Vardas, Panos Karkavitsas, Nikolaos |
| description | The increase in heart rate during exercise is considered to be attributed to sympathetic system activation combined with parasympathetic withdrawal. The prognostic importance of the chronotropic response to exercise and heart rate recovery 1 minute after exercise has already been established. The purpose of this study was to evaluate heart rate recovery as an index of myocardial ischemia, by correlating heart rate recovery with known parameters of myocardial ischemia.
Included in the study were 304 consecutive patients (73% men), aged 34 to 82 years. Patients whose heart rate recovery value or myocardial perfusion imaging could have been influenced by factors other than ischemic disease were excluded from the study. The patients underwent single photon emission computed tomography myocardial perfusion imaging combined with symptom-limited exercise testing with thallium 201 or technetium 99m tetrofosmin. The value for heart rate recovery was defined as the decrease in heart rate from peak exercise to 1 minute after termination of exercise. For semiquantitation of the scintigram, the uptake of the radiotracer was graded on a scale from 0 to 4. Twenty-one beats per minute was defined as the lowest normal value for heart rate recovery. We found 74 patients (24%) with an abnormal value. We also found a significant correlation between heart rate recovery 1 minute after exercise and stress myocardial perfusion score. In addition, there was a statistically significant relationship between heart rate recovery and chronotropic variables. Patients with an abnormal value of heart rate recovery were generally of an older age, were more likely men, had a higher frequency of risk factors for coronary artery disease, were mostly taking cardioactive medications, had lower efficiency during treadmill testing, and had more pathologic findings on the scintigram.
Myocardial ischemia, as assessed by myocardial perfusion imaging, is an important correlate of heart rate recovery. There is a significant correlation between chronotropic variables during exercise testing and heart rate recovery 1 minute after exercise. It seems that the heart rate recovery value 1 minute after peak exercise may be considered a reliable index of the severity of myocardial ischemia. |
| doi_str_mv | 10.1016/S1071-3581(03)00530-0 |
| format | Article |
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Included in the study were 304 consecutive patients (73% men), aged 34 to 82 years. Patients whose heart rate recovery value or myocardial perfusion imaging could have been influenced by factors other than ischemic disease were excluded from the study. The patients underwent single photon emission computed tomography myocardial perfusion imaging combined with symptom-limited exercise testing with thallium 201 or technetium 99m tetrofosmin. The value for heart rate recovery was defined as the decrease in heart rate from peak exercise to 1 minute after termination of exercise. For semiquantitation of the scintigram, the uptake of the radiotracer was graded on a scale from 0 to 4. Twenty-one beats per minute was defined as the lowest normal value for heart rate recovery. We found 74 patients (24%) with an abnormal value. We also found a significant correlation between heart rate recovery 1 minute after exercise and stress myocardial perfusion score. In addition, there was a statistically significant relationship between heart rate recovery and chronotropic variables. Patients with an abnormal value of heart rate recovery were generally of an older age, were more likely men, had a higher frequency of risk factors for coronary artery disease, were mostly taking cardioactive medications, had lower efficiency during treadmill testing, and had more pathologic findings on the scintigram.
Myocardial ischemia, as assessed by myocardial perfusion imaging, is an important correlate of heart rate recovery. There is a significant correlation between chronotropic variables during exercise testing and heart rate recovery 1 minute after exercise. It seems that the heart rate recovery value 1 minute after peak exercise may be considered a reliable index of the severity of myocardial ischemia.</description><identifier>ISSN: 1071-3581</identifier><identifier>EISSN: 1532-6551</identifier><identifier>DOI: 10.1016/S1071-3581(03)00530-0</identifier><identifier>PMID: 14569243</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Arrhythmias, Cardiac - complications ; Arrhythmias, Cardiac - diagnosis ; Arrhythmias, Cardiac - diagnostic imaging ; Arrhythmias, Cardiac - etiology ; Arrhythmias, Cardiac - physiopathology ; Cardiovascular disease ; Electrocardiography - methods ; Exercise Test ; Female ; Fitness equipment ; Heart ; Heart Rate ; Heart rate recovery ; Hemostasis ; Humans ; Ischemia ; Male ; Medical imaging ; Middle Aged ; myocardial ischemia ; Myocardial Ischemia - diagnosis ; Myocardial Ischemia - diagnostic imaging ; Myocardial Ischemia - physiopathology ; myocardial perfusion imaging ; Radionuclide Imaging ; Recovery of Function ; Reproducibility of Results ; Risk Assessment ; Sensitivity and Specificity ; Statistics as Topic ; treadmill testing</subject><ispartof>Journal of nuclear cardiology, 2003-09, Vol.10 (5), p.498-505</ispartof><rights>2003 American Society of Nuclear Cardiology</rights><rights>American Society of Nuclear Cardiology 2003.</rights><rights>American Society of Nuclear Cardiology 2003</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c416t-34494e770f9dfb595946efb03be444b11d5a542b3c4527c16d30b91391efd10b3</citedby><cites>FETCH-LOGICAL-c416t-34494e770f9dfb595946efb03be444b11d5a542b3c4527c16d30b91391efd10b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14569243$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Georgoulias, Panagiotis</creatorcontrib><creatorcontrib>Orfanakis, Alexandros</creatorcontrib><creatorcontrib>Demakopoulos, Nikolaos</creatorcontrib><creatorcontrib>Xaplanteris, Petros</creatorcontrib><creatorcontrib>Mortzos, Georgios</creatorcontrib><creatorcontrib>Vardas, Panos</creatorcontrib><creatorcontrib>Karkavitsas, Nikolaos</creatorcontrib><title>Abnormal heart rate recovery immediately after treadmill testing: Correlation with clinical, exercise testing, and myocardial perfusion parameters</title><title>Journal of nuclear cardiology</title><addtitle>J Nucl Cardiol</addtitle><description>The increase in heart rate during exercise is considered to be attributed to sympathetic system activation combined with parasympathetic withdrawal. The prognostic importance of the chronotropic response to exercise and heart rate recovery 1 minute after exercise has already been established. The purpose of this study was to evaluate heart rate recovery as an index of myocardial ischemia, by correlating heart rate recovery with known parameters of myocardial ischemia.
Included in the study were 304 consecutive patients (73% men), aged 34 to 82 years. Patients whose heart rate recovery value or myocardial perfusion imaging could have been influenced by factors other than ischemic disease were excluded from the study. The patients underwent single photon emission computed tomography myocardial perfusion imaging combined with symptom-limited exercise testing with thallium 201 or technetium 99m tetrofosmin. The value for heart rate recovery was defined as the decrease in heart rate from peak exercise to 1 minute after termination of exercise. For semiquantitation of the scintigram, the uptake of the radiotracer was graded on a scale from 0 to 4. Twenty-one beats per minute was defined as the lowest normal value for heart rate recovery. We found 74 patients (24%) with an abnormal value. We also found a significant correlation between heart rate recovery 1 minute after exercise and stress myocardial perfusion score. In addition, there was a statistically significant relationship between heart rate recovery and chronotropic variables. Patients with an abnormal value of heart rate recovery were generally of an older age, were more likely men, had a higher frequency of risk factors for coronary artery disease, were mostly taking cardioactive medications, had lower efficiency during treadmill testing, and had more pathologic findings on the scintigram.
Myocardial ischemia, as assessed by myocardial perfusion imaging, is an important correlate of heart rate recovery. There is a significant correlation between chronotropic variables during exercise testing and heart rate recovery 1 minute after exercise. It seems that the heart rate recovery value 1 minute after peak exercise may be considered a reliable index of the severity of myocardial ischemia.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Arrhythmias, Cardiac - complications</subject><subject>Arrhythmias, Cardiac - diagnosis</subject><subject>Arrhythmias, Cardiac - diagnostic imaging</subject><subject>Arrhythmias, Cardiac - etiology</subject><subject>Arrhythmias, Cardiac - physiopathology</subject><subject>Cardiovascular disease</subject><subject>Electrocardiography - methods</subject><subject>Exercise Test</subject><subject>Female</subject><subject>Fitness equipment</subject><subject>Heart</subject><subject>Heart Rate</subject><subject>Heart rate recovery</subject><subject>Hemostasis</subject><subject>Humans</subject><subject>Ischemia</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Middle Aged</subject><subject>myocardial ischemia</subject><subject>Myocardial Ischemia - diagnosis</subject><subject>Myocardial Ischemia - diagnostic imaging</subject><subject>Myocardial Ischemia - physiopathology</subject><subject>myocardial perfusion imaging</subject><subject>Radionuclide Imaging</subject><subject>Recovery of Function</subject><subject>Reproducibility of Results</subject><subject>Risk Assessment</subject><subject>Sensitivity and Specificity</subject><subject>Statistics as Topic</subject><subject>treadmill testing</subject><issn>1071-3581</issn><issn>1532-6551</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkd9qFDEUh4NYbLv6CEpQKBY6mkySmY03pSz-g4IX6nXIZM7YlMxke5Jp3dfwic12twiCeJVD-M7vHM5HyHPO3nDGm7dfOWt5JdSSv2bilDElWMUekSOuRF01SvHHpX5ADslxSteMMS20fkIOuVSNrqU4Ir8uuiniaAO9AouZos1AEVy8BdxQP47Q-_IVNtQOGZBmBNuPPgSaIWU__XhHVxERgs0-TvTO5yvqgp-8s-GMwk9A5xM8wGfUTj0dN9FZLLmBrgGHOW071xbtCGVEekoOBhsSPNu_C_L9w_tvq0_V5ZePn1cXl5WTvMmVkFJLaFs26H7olFZaNjB0THQgpew475VVsu6Ek6puHW96wTrNheYw9Jx1YkFOdrlrjDdzWdCMPjkIwU4Q52RaXm9xXcCXf4HXccap7GZaIZulLhcu0Kt_QXW7bGux5LIplNpRDmNKCINZox8tbgxnZuvV3Hs1W2mGCXPvtRQL8mKfPndFyZ-uvcgCnO8AKBe79YAmOQ-TK_qKzWz66P8z4jdDrrPT</recordid><startdate>20030901</startdate><enddate>20030901</enddate><creator>Georgoulias, Panagiotis</creator><creator>Orfanakis, Alexandros</creator><creator>Demakopoulos, Nikolaos</creator><creator>Xaplanteris, Petros</creator><creator>Mortzos, Georgios</creator><creator>Vardas, Panos</creator><creator>Karkavitsas, Nikolaos</creator><general>Elsevier Inc</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20030901</creationdate><title>Abnormal heart rate recovery immediately after treadmill testing: Correlation with clinical, exercise testing, and myocardial perfusion parameters</title><author>Georgoulias, Panagiotis ; 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The prognostic importance of the chronotropic response to exercise and heart rate recovery 1 minute after exercise has already been established. The purpose of this study was to evaluate heart rate recovery as an index of myocardial ischemia, by correlating heart rate recovery with known parameters of myocardial ischemia.
Included in the study were 304 consecutive patients (73% men), aged 34 to 82 years. Patients whose heart rate recovery value or myocardial perfusion imaging could have been influenced by factors other than ischemic disease were excluded from the study. The patients underwent single photon emission computed tomography myocardial perfusion imaging combined with symptom-limited exercise testing with thallium 201 or technetium 99m tetrofosmin. The value for heart rate recovery was defined as the decrease in heart rate from peak exercise to 1 minute after termination of exercise. For semiquantitation of the scintigram, the uptake of the radiotracer was graded on a scale from 0 to 4. Twenty-one beats per minute was defined as the lowest normal value for heart rate recovery. We found 74 patients (24%) with an abnormal value. We also found a significant correlation between heart rate recovery 1 minute after exercise and stress myocardial perfusion score. In addition, there was a statistically significant relationship between heart rate recovery and chronotropic variables. Patients with an abnormal value of heart rate recovery were generally of an older age, were more likely men, had a higher frequency of risk factors for coronary artery disease, were mostly taking cardioactive medications, had lower efficiency during treadmill testing, and had more pathologic findings on the scintigram.
Myocardial ischemia, as assessed by myocardial perfusion imaging, is an important correlate of heart rate recovery. There is a significant correlation between chronotropic variables during exercise testing and heart rate recovery 1 minute after exercise. It seems that the heart rate recovery value 1 minute after peak exercise may be considered a reliable index of the severity of myocardial ischemia.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>14569243</pmid><doi>10.1016/S1071-3581(03)00530-0</doi><tpages>8</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Arrhythmias, Cardiac - complications Arrhythmias, Cardiac - diagnosis Arrhythmias, Cardiac - diagnostic imaging Arrhythmias, Cardiac - etiology Arrhythmias, Cardiac - physiopathology Cardiovascular disease Electrocardiography - methods Exercise Test Female Fitness equipment Heart Heart Rate Heart rate recovery Hemostasis Humans Ischemia Male Medical imaging Middle Aged myocardial ischemia Myocardial Ischemia - diagnosis Myocardial Ischemia - diagnostic imaging Myocardial Ischemia - physiopathology myocardial perfusion imaging Radionuclide Imaging Recovery of Function Reproducibility of Results Risk Assessment Sensitivity and Specificity Statistics as Topic treadmill testing |
| title | Abnormal heart rate recovery immediately after treadmill testing: Correlation with clinical, exercise testing, and myocardial perfusion parameters |
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