Document Detail


Is there a better way to predict death using heart rate recovery?
MedLine Citation:
PMID:  17007171     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Heart rate recovery (HRR) during exercise testing is an independent predictor of prognosis. The relative predictive power of computational analysis of HRR as a function of resting and maximum heart rate (HR) compared with direct measurement of the drop in HR has not been determined. HYPOTHESIS: We aimed to improve on the prognostic value of HRR by the use of mathematical representations of HRR kinetics. METHODS: In all, 2,193 patients who underwent exercise testing, coronary angiography, and clinical evaluation were followed up for 10.2 +/- 3.6 years. Mathematical functions were used to model HRR as a function of resting (HR(Rest)), maximum HR (HR(Peak)) and time (t): (a) HRR= HR(Rest) + (HR(peak) - HR(Rest)) X e(-kt) and (b) HRR= HR(Rest) + (HR(peak) - HR(Rest)) e(-kt2) RESULTS: Equation (b) provided the best fit of the recovery HR curve. An abnormal HRR at 2 min was a better predictor of mortality than HRR at 1, 3, or 5 min. At 2 min, HRR also predicted mortality better than computational models of HRR, relating HRR as a function of maximum and resting HRs. After adjusting for univariately significant predictors of mortality, HRR, age, exercise capacity, and maximum HR were chosen in order as the best predictors of mortality. CONCLUSION: Even though the computational models of HRR and the determination of HRR at different time intervals were significant predictors of mortality, the simple discrete measure of HRR at 2 min was the best predictor of mortality. At 2 min, HRR outperformed age, METs, and maximum exercise HR in predicting all-cause mortality.
Authors:
Dmitry David Gorelik; David Hadley; Jonathan Myers; Victor Froelicher
Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Clinical cardiology     Volume:  29     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-09-29     Completed Date:  2007-01-09     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  399-404     Citation Subset:  IM    
Affiliation:
Stanford University VA Palo Alto Health Care System, Palo Alto, California 94304, USA. dmitrygorelik@yahoo.com
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Analysis of Variance
Coronary Angiography
Coronary Artery Disease / diagnosis,  mortality*,  physiopathology*,  radiography
Exercise Test
Exercise Tolerance
Follow-Up Studies
Heart Rate*
Humans
Male
Middle Aged
Predictive Value of Tests
Prognosis
Proportional Hazards Models
Recovery of Function*
Survival Analysis
Time Factors
United States / epidemiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  The effect of a six-week program of yoga and meditation on brachial artery reactivity: do psychosoci...
Next Document:  Prognostic value of serum biomarkers in association with TIMI risk score for acute coronary syndrome...