Document Detail

Long-term prognostic value of heart-rate recovery after treadmill testing in patients with diabetes mellitus.
MedLine Citation:
PMID:  18499284     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Heart-rate recovery (HRR) is considered to be an independent predictor of cardiac and all-cause mortality. We examined the long-term prognostic value of HRR in patients suffering from diabetes mellitus. METHODS: In this study, we included 258 consecutive patients. Patients whose HRR value or myocardial perfusion imaging could have been influenced by factors other than myocardial ischaemia, were excluded. The value of HRR was defined as the decrease in the heart-rate from peak exercise to 1 min after the termination of the exercise. All patients underwent SPECT myocardial perfusion imaging combined with exercise testing. Cardiovascular death and non-fatal myocardial infarction were considered as hard cardiac events, while late revascularization procedures as soft events. Cox proportional-hazard models were applied to evaluate the association between HRR and the investigated outcome. RESULTS: During the follow-up period (30.8+/-6.9 months), hard cardiac events occurred in 21 (8%) patients (15 with abnormal HRR value, p<0.001), while 35 (14%) patients underwent revascularization (31 with abnormal HRR value, p<0.001). Considering it as a continuous variable, HRR was a strong predictor for both hard cardiac (coefficient=-0.41, SE=0.052, p<0.001) and soft cardiac events (coefficient=-0.63, SE=0.058, p<0.001). After adjustments were made for potential confounders, including scintigraphic variables, abnormal HRR remained an independent predictor for hard and soft cardiac events (p<0.001). CONCLUSION: Our results suggest that among patients with diabetes, a decreased HRR is a significant independent predictor of hard and soft cardiac events.
Panagiotis Georgoulias; Nikolaos Demakopoulos; Varvara Valotassiou; Alexandros Orfanakis; Alexia Zaganides; Ioannis Tsougos; Ioannis Fezoulidis
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Publication Detail:
Type:  Journal Article     Date:  2008-05-21
Journal Detail:
Title:  International journal of cardiology     Volume:  134     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-13     Completed Date:  2009-07-16     Revised Date:  2009-12-09    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  67-74     Citation Subset:  IM    
Department of Nuclear Medicine, Medical School, University of Thessaly and University Hospital of Larissa, Larissa, Greece.
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MeSH Terms
Diabetes Mellitus, Type 1 / drug therapy,  mortality*
Diabetes Mellitus, Type 2 / drug therapy,  mortality*
Disease-Free Survival
Exercise Test
Follow-Up Studies
Heart Rate / physiology*
Hypoglycemic Agents / therapeutic use
Insulin / therapeutic use
Middle Aged
Myocardial Infarction / mortality,  physiopathology,  radionuclide imaging
Myocardial Ischemia / mortality*,  physiopathology,  radionuclide imaging*
Predictive Value of Tests
Proportional Hazards Models
Risk Factors
Tomography, Emission-Computed, Single-Photon*
Reg. No./Substance:
0/Hypoglycemic Agents; 11061-68-0/Insulin
Comment In:
Int J Cardiol. 2009 Nov 12;137(3):187-8   [PMID:  19446894 ]

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