Chronotropic incompetence and mortality in middle-aged men with known or suspected coronary heart disease.
Chronotropic incompetence and mortality in middle-aged men with known or suspected coronary heart disease.
复制标题
患有已知或疑似冠心病的中年男性变时性功能不全和死亡率。
作者：
K. Savonen;V. Kiviniemi;J. Laukkanen;T. Lakka;T. Rauramaa;J. Salonen;R. Rauramaa
旨在
目的是研究运动试验中心率（HR）从最大作功能力的40%增加到100%（HR 40 -100）是否能独立预测已知或疑似冠心病（CHD）男性的死亡率。
方法和结果
受试者为294名男性，年龄42-61岁，来自芬兰东部，患有已知或疑似CHD，但基线时未使用降低HR的药物。在休息时和最大限度的极限运动试验期间测量HR。在平均11.0年的随访中，有61例全因死亡。在Cox多变量模型中，死亡率增加41%（95%置信区间，12-79%），1-SD（15 b. p.m.）HR 40 -100的减量。心率从休息时增加到最大工作能力的40%与死亡风险增加无关。在HR 40 -100和HR 100 b. p.m.时达到的工作量之间观察到协同作用，因此与这些变量值高的男性相比，这两个HR变量值低的男性预后特别不良。
结论
在已知或怀疑患有CHD的男性中，心率增加减弱，特别是在最大运动试验的后半部分，是死亡的独立预测因子。
AIMS
The objective is to study whether a heart rate (HR) increase from 40 to 100% of maximal work capacity in the exercise test (HR40-100) independently predicts mortality in men with known or suspected coronary heart disease (CHD).
METHODS AND RESULTS
The subjects were 294 men, 42-61 years of age, from eastern Finland with known or suspected CHD but without use of HR-lowering medication at baseline. HR was measured at rest and during a maximal, symptom-limited exercise test. During an average follow-up of 11.0 years, there were 61 all-cause deaths. In Cox-multivariable model, mortality increased by 41% (95% confidence interval, 12-79%) with a 1-SD (15 b.p.m.) decrement in HR40-100. HR increase from rest to 40% of maximal work capacity was not associated with an increased risk of death. Synergism was observed between HR40-100 and workload achieved at HR of 100 b.p.m. so that men having low values for both these HR variables had a particularly adverse prognosis compared with men with high values for these variables.
CONCLUSION
An attenuated HR increase particularly during the latter half of a maximal exercise test is an independent predictor of death in men with known or suspected CHD.
最大运动测试期间心率损伤的放射性核素成像相关性。
影响因子：
24
作者：
Hammond,HK;Kelly,TL;Froelicher,V
通讯作者：
Froelicher,V