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Cardiac autonomic functions derived from short-term heart rate variability recordings associated with heart rate recovery after treadmill exercise test in young individuals

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Abstract

Analysis of short-term heart rate variability (HRV) may provide useful information about autonomic nervous control of heart rate recovery. We studied 495 individuals (273 men), age range 19–85 years, submitted to treadmill exercise tests and short-term HRV evaluations over time (standard deviation of the normal-to-normal interval [SDNN], the square root of the mean squared differences of successive normal-to-normal intervals [RMSSD], the number of interval differences of successive normal-to-normal intervals greater than 50 ms [NN50 count], the proportion derived by dividing NN50 count by the total number of normal-to-normal intervals [pNN50]) and frequency (low-frequency power [LF], high-frequency power [HF], total power) domains. Among 495 patients, 106 patients (68 men) were elderly (age  ≥ 65 years). Male gender and hypertension were significantly higher in elderly patients. The young patients had higher HRR after exercise. HRR at 4 min (54 ± 13 vs 60 ± 12 beats/min; P = 0.003) was the most significant predictor for positive exercise test result. In the young group, both time domain measures (SDNN: correlation coefficient 0.34, P < 0.001; RMSSD: correlation coefficient 0.37, P < 0.001) and frequency domain measures (LF: correlation coefficient 0.21, P < 0.001; HF: correlation coefficient 0.13, P = 0.01; total power: correlation coefficient 0.22, P < 0.001) were significantly associated with HRR at 4 min. HRR at 4 min was significantly associated with short-term HRV of time and frequency domains in young individuals, but not elderly ones, receiving treadmill exercise test.

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References

  1. Cole CR, Blackstone EH, Pashkow FJ, Sander CE, Lauer MS (1999) Heart rate recovery immediately after exercise as a predictor of mortality. N Engl J Med 341:1351–1357

    Article  PubMed  CAS  Google Scholar 

  2. Jouvn X, Empana JP, Schwartz PJ, Desnos M, Courbon D, Ducimetière P (2005) Heart rate profile during exercise as a predictor of sudden death. N Engl J Med 352:1951–1958

    Article  Google Scholar 

  3. Lauer MS, Okin PM, Larson MG, Evans JC, Levy D (1998) Impaired heart rate response to graded exercise: prognostic implications of chronotropic incompetence in the Framingham Heart Study. Circulation 93:1520–1526

    Google Scholar 

  4. Lauer M, Mehta R, Pashkow FJ, Okin PM, Lee K, Marwick TH (1998) Association of chronotropic incompetence with myocardial ischemia and prognosis. J Am Coll Cardiol 32:1280–1286

    Article  PubMed  CAS  Google Scholar 

  5. Lipinski MJ, Vectrovec GW, Froelicher VF (2004) Importance of the first two minutes after exercise treadmill testing in predicting mortality and the presence of coronary artery disease in men. Am J Cardiol 93:445–449

    Article  PubMed  Google Scholar 

  6. Ushiyama T, Mizushige K, Wakabayashi H, Nakatsu T, Ishimura K, Tsuboi Y, Maeta H, Suzuki Y (2008) Analysis of heart rate variability as an index of noncardiac surgical stress. Heart Vessels 23:53–59

    Article  PubMed  Google Scholar 

  7. Cheung EW, Lam WW, Cheung SC, Cheung YF (2008) Functional implications of the right ventricular myocardial performance index in patients after surgical repair of tetralogy of Fallot. Heart Vessels 23:112–117

    Article  PubMed  Google Scholar 

  8. Biselli PM, Guerzoni AR, de Godoy MF, Pavarino-Bertelli EC, Goloni-Bertollo EM (2008) Vascular endothelial growth factor genetic variability and coronary artery disease in Brazilian population. Heart Vessels 23:371–375

    Article  PubMed  Google Scholar 

  9. Schwartz PJ, La Rovere MT, Vanoli E (1992) Autonomic nervous system and sudden cardiac death: experimental basis and clinical observations for post-myocardial infarction risk stratification. Circulation 85:177–191

    Google Scholar 

  10. Lown B, Verrier RL (1976) Neural activity and ventricular fibrillation. N Engl J Med 94:1165–1170

    Google Scholar 

  11. Schwartz PJ, Vanoli E, Stramba-Badiale M, De Ferrari GM, Billman GE, Foreman RD (1988) Autonomic mechanisms and sudden death: new insights from analysis of baroreceptor reflexes in conscious dogs with and without a myocardial infarction. Circulation 78:969–979

    PubMed  CAS  Google Scholar 

  12. Imai K, Sato H, Hori M, Kusuoka H, Ozaki H, Yokoyama H, Takeda H, Inoue M, Kamada T (1994) Vaguely mediated heart rate recovery after exercise is accelerated in athletes but blunted in patients with chronic heart failure. J Am Coll Cardiol 24:1529–1535

    Article  PubMed  CAS  Google Scholar 

  13. Nishime EO, Cole R, Blackstone EH, Pashkow FJ, Lauer MS (2000) Heart rate recovery and treadmill exercise score as predictors of mortality in patients referred for exercise ECG. JAMA 284:1392–1398

    Article  PubMed  CAS  Google Scholar 

  14. Dreifus LS, Agarwal JB, Botvinick EH, American College of Cardiology Cardiovascular Technology Assessment Committee (1993) Heart rate variability for risk stratification of life-threatening arrhythmias. J Am Coll Cardiol 22:948–950

    Google Scholar 

  15. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology (1996) Heart rate variability: standards of measurement, physiological interpretation, and clinical use. Circulation 93:1043–1065

    Google Scholar 

  16. Akselrod S, Gordon D, Ubel FA, Shannon DC, Berger AC, Cohen RJ (1981) Power spectrum analysis of heart rate fluctuation: a quantitative probe of beat-to-beat cardiovascular control. Science 213:220–222

    Article  PubMed  CAS  Google Scholar 

  17. Pomeranz B, Macaulay RJ, Caudill MA, Kutz I, Adam D, Gordon D, Kilborn KM, Barger AC, Shannon DC, Cohen RJ, Benson H (1985) Assessment of autonomic function in humans by heart rate spectral analysis. Am J Physiol 248:H151–H153

    PubMed  CAS  Google Scholar 

  18. Task Force of The European Society of Cardiology and The North American Society of Pacing and Electrophysiology (1996) Heart rate variability: standards of measurement, physiological interpretation, and clinical use. Eur Heart J 17:354-381

    Google Scholar 

  19. Gibbons RJ, Balady GJ, Beasley JW, Bricker JT, Duvernoy WF, Froelicher VF, Mark DB, Marwick TH, McCallister BD, Thompson PD Jr, Winters WL, Yanowitz FG, Ritchie JL, Gibbons RJ, Cheitlin MD, Eagle KA, Gardner TJ, Garson A Jr, Lewis RP, O’Rourke RA, Ryan TJ (1997) ACC/AHA guidelines for exercise testing. A report of the American College of Cardiology/American Heart Association task force on practice guidelines (Committee on Exercise Testing). J Am Coll Cardiol 30:260–311

    Article  PubMed  CAS  Google Scholar 

  20. Mara S, Redberg RF, Cui Y, Whiteman MK, Flaws JA, Sharrett AR, Blumenthal RS (2003) Ability of exercise testing to predict cardiovascular and all-cause death in asymptomatic women: a 20-year follow-up of the lipid research clinics prevalence study. JAMA 290:1600–1607

    Article  Google Scholar 

  21. Brinkworth GD, Noakes M, Buckley JD, Clifton PM (2006) Weight loss improves heart rate recovery in overweight and obese men with features of the metabolic syndrome. Am Heart J 152:693.e1–693.e6

    Article  Google Scholar 

  22. Vivekananthan DP, Blackstone EH, Pothier CE, Lauer MS (2003) Heart rate recovery after exercise is a predictor of mortality, independent of the angiographic severity of coronary disease. J Am Coll Cardiol 42:831–838

    Article  PubMed  Google Scholar 

  23. Panzer C, Lauer MS, Brieke A, Blackstone E, Hoogwerf B (2002) Association of fasting plasma glucose with heart rate recovery in healthy adults. A population-based study. Diabetes 51:803–807

    Article  PubMed  CAS  Google Scholar 

  24. Cheng YL, Lauer MS, Earnest CP, Church TS, Kampert JB, Gibbons LW, Blair SN (2003) Heart rate recovery following maximal exercise testing as a predictor of cardiovascular disease and all cause mortality in men with diabetes. Diabetes Care 26:2052–2057

    Article  PubMed  Google Scholar 

  25. Watanabe J, Thamilarasan M, Blackstone EH, Thomas JD, Lauer MS (2001) Heart rate recovery immediately after treadmill exercise and left ventricular systolic dysfunction as predictors of mortality: the case of stress echocardiography. Circulation 104:1911–1916

    PubMed  CAS  Google Scholar 

  26. Pitsavos CH, Chrysohoou C, Panagiotakos DB, Kokkinos P, Skoumas J, Papaioannou I, Michaelides AP, Singh S, Stefanadis CI (2004) Exercise capacity and heart rate recovery as predictors of coronary heart disease events, in patients with heterozygous familial hypercholesterolemia. Atherosclerosis 173:347–352

    Article  PubMed  CAS  Google Scholar 

  27. Georgoulias P, Orfanakis A, Demakopoulos N, Xaplanteris P, Mortzos G, Vardas P, Karkavitsas N (2003) Abnormal heart rate recovery immediately after treadmill testing: correlation with clinical, exercise testing, and myocardial perfusion parameters. J Nucl Cardiol 10:498–505

    Article  PubMed  Google Scholar 

  28. Georgoulias P, Demakopoulos N, Orfanakis A, Xydis K, Xaplanteris P, Vardas P, Fezoulidis I (2007) Evaluation of abnormal heart-rate recovery after exercise testing in patients with diabetes mellitus: correlation with myocardial SPECT and chronotropic parameters. Nucl Med Commun 28:165–171

    Article  PubMed  Google Scholar 

  29. Frenneaux MP (2004) Autonomic changes in patients with heart failure and in post-myocardial infarction patients. Heart 90:1248–1255

    Article  PubMed  CAS  Google Scholar 

  30. Cole CR, Foody JM, Blackstone EH, Lauer MS (2000) Heart rate recovery after submaximal exercise testing as a predictor of mortality in a cardiovascularly healthy cohort. Ann Intern Med 132:552–555

    PubMed  CAS  Google Scholar 

  31. Antelmi I, Chuang EY, Grupi CJ, Latorre Mdo R, Mansur AJ (2008) Heart rate recovery after treadmill electrocardiographic exercise stress test and 24-hour heart rate variability in healthy individuals. Arq Bras Cardiol 90:380–385

    Article  PubMed  Google Scholar 

  32. Sundaram S, Shoushtari C, Carnethon M (2004) Autonomic and nonautonomic determinants of heart rate recovery. Heart Rhythm 1:S100–S101

    Google Scholar 

  33. Lahiri MK, Kannankeril PJ, Goldberger JJ (2008) Assessment of autonomic function in cardiovascular disease. J Am Coll Cardiol 51:1725–1733

    Article  PubMed  Google Scholar 

  34. Saul JP (1990) Beat-to-beat variations of heart rate reflect modulation of cardiac autonomic outflow. News Physiol Sci 5:32–37

    Google Scholar 

  35. Thayer JF, Lane RD (2007) The role of vagal function in the risk for cardiovascular disease and mortality. Biol Psychol 74:224–242

    Article  PubMed  Google Scholar 

  36. Antelmi I, de Paula RS, Shinzato AR, Peres CA, Mansur AJ, Grupi CJ (2004) Influence of age, gender, body mass index, and functional capacity on heart rate variability in a cohort of subjects without heart disease. Am J Cardiol 93:381–385

    Article  PubMed  Google Scholar 

  37. Ergun U, Demirci M, Nurlu G, Komürcü F (2008) Power spectral analysis of heart rate variability: normal values of subjects over 60 years old. Int J Neurosci 118:1165–1173

    Article  PubMed  Google Scholar 

  38. Paolisso G, Manzella D, Barbieri M, Rizzo MR, Gambardella A, Varricchio M (1999) Baseline heart rate variability in healthy centenarians: differences compared with aged subjects (>75 years old). Clin Sci 97:579–584

    Article  PubMed  CAS  Google Scholar 

  39. Ooie T, Saikawa T, Hara M, Ono H, Seike M, Sakata T (1999) H2-blocker modulates heart rate variability. Heart Vessels 14:137–142

    Article  PubMed  CAS  Google Scholar 

  40. Atherton JJ, Blackman DJ, Moore TD, Bachmann AW, Tunny TJ, Thomson HL, Gordon RD, Frenneaux MP (1998) Diastolic ventricular interaction in chronic heart failure: relation to heart rate variability and neurohumoral status. Heart Vessels 13:269–277

    PubMed  CAS  Google Scholar 

  41. Ooie T, Takakura T, Shiraiwa H, Yoshimura A, Hara M, Saikawa T (1998) Change in heart rate variability preceding ST elevation in a patient with vasospastic angina pectoris. Heart Vessels 13:40–44

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, 138 Sheng-Li Road, Tainan, 704, Taiwan

    Ju-Yi Chen, Wei-Chuan Tsai, Cheng-Han Lee, Po-Sheng Chen, Yi-Heng Li, Liang-Miin Tsai, Jyh-Hong Chen & Li-Jen Lin

  2. Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Ju-Yi Chen

  3. Institute of Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan

    Yungling Leo Lee

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  1. Ju-Yi Chen
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Chen, JY., Lee, Y.L., Tsai, WC. et al. Cardiac autonomic functions derived from short-term heart rate variability recordings associated with heart rate recovery after treadmill exercise test in young individuals. Heart Vessels 26, 282–288 (2011). https://doi.org/10.1007/s00380-010-0048-6

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