Heart rate recovery after treadmill exercise testing and risk of cardiovascular disease events (the Framingham Heart Study)
Heart rate recovery after treadmill exercise testing and risk of cardiovascular disease events (the Framingham Heart Study)
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DOI：
10.1016/s0002-9149(02)02706-6
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发表时间：
2002-10-15
影响因子：
2.8
通讯作者：
Vasan, RS
中科院分区：
文献类型：
--
作者：
Morshedi-Meibodi, A;Larson, MG;Vasan, RS
分级运动试验后心率（HR）恢复延迟与临床样本中全因死亡率增加相关。之前没有研究检查运动后HR恢复与冠心病（CHD）和心血管疾病（CVD）事件发生率的相关性。我们评估了2，967例无心血管疾病并在常规检查中进行了平板运动试验（布鲁斯方案）的Fracture研究受试者（1，400例男性，平均年龄43岁）。我们研究了HR恢复指数（从运动峰值开始HR下降）与首次CHD或CVD事件发生率和全因死亡率的关系，并对已确定的CVD危险因素进行了调整。在随访期间（平均15年），214例受试者发生CHD事件（156例男性），312例发生CVD事件（207例男性），167例死亡（105例男性）。在多变量模型中，连续HR恢复指数与CHD或CVD事件的发生率或全因死亡率无关。然而，在评估基于五分位数的临界点的模型中，运动后1分钟的心率（HR最大下降）与冠心病风险降低相关（风险比vs底部4个五分位数0.54，95%置信区间[CI]，0.32 - 0.93）和CVD（风险比0.61，95% CI 0.41至0.93），但非全因死亡率（风险比0.99，95% CI 0.60至1.62）。在我们以社区为基础的样本中，HR恢复指数与全因死亡率无关。运动后HR迅速恢复与CHD和CVD事件的风险降低相关。这些发现应该在其他环境中得到证实。(C)2002年，Excerpta Medica，Inc.
A delayed heart rate (HR) recovery after graded exercise testing has been associated with increased all-cause mortality in clinic-based samples. No prior study has examined the association of HR recovery after exercise with the incidence of coronary heart disease (CHD) and cardiovascular disease (CVD) events. We evaluated 2,967 Framingham study subjects (1,400 men, mean age 43 years) who were free of CVD and underwent a treadmill exercise test (Bruce protocol) at a routine examination. We examined the relations of HR recovery indexes (decrease in HR from peak exercise) to the incidence of a first CHD or CVD event and all-cause mortality, adjusting for established CVD risk factors. During follow-up (mean 15 years), 214 subjects experienced a CHD event (156 men), 312 developed a CVD event (207 men), and 167 died (105 men). In multivariable models, continuous HR recovery indexes were not associated with the incidence of CHD or CVD events, or with all-cause mortality. However, in models evaluating quintile-based cut points, the top quintile of HR recovery (greatest decline in HR) at 1-minute after exercise was associated with a lower risk of CHD (hazards ratio vs bottom 4 quintiles 0.54, 95% confidence interval [CI], 0.32 to 0.93) and CVD (hazards ratio 0.61, 95% CI 0.41 to 0.93), but not all-cause mortality (hazards ratio 0.99, 95% CI 0.60 to 1.62). In our community-based sample, HR recovery indexes were not associated with all-cause mortality. A very rapid HR recovery immediately after exercise was associated with lower risk of CHD and CVD events. These findings should be confirmed in other settings. (C) 2002 by Excerpta Medica, Inc.