HEART RATE RECOVERY FOLLOWING PEAK EXERCISE IS ASSOCIATED WITH RESTING DIASTOLIC DYSFUNCTION IN HIV+ SUBJECTS

Abstract

Objectives The objective was to examine the relationship between heart rate recovery (HRR) (peak HR-HR at each minute post-exercise) and diastolic function in HIV+ subjects (HIV+) and HIV-negative controls (Cntl). Methods HIV+ (n=20, 40 ± 7 yrs) and Cntl subjects (n=10, 41 ± 10 yrs) underwent maximal exercise testing on a cycle ergometer with oxygen consumption and EKG monitoring. Resting 2D and Doppler echocardiography was performed on a separate day. Results Although no significant differences between groups, peak HR and peakVO2 was significantly associated with 3, 4, and 5min HRR, and were used as covariates for comparison between groups. HRR at 3min(HIV+= 50.7 ± 3 vs. Cntl= 64.2 ± 4 bpm, p<0.007), 4min(HIV+= 56.5 ± 2 vs. Cntl=68.9 ± 4, p<0.01) and 5min (HIV+= 61.9 ± 3 vs. Cntl= 72.0 ± 4, p<0.06) was significantly lower in HIV+ than Cntl. HRR at 3min was associated with septal em (r=0.37, p<0.05), left ventricular mass index (LVMI)(r=-0.42, p<0.03), and fasting glucose (r=-0.37, p<0.04). HRR at 4min was associated with LVMI (r=-0.32, p<0.009), fasting glucose (r=-0.43, p<0.02) and serum triglycerides (TG)(r=-0.39, p<0.04). HRR at 5min was associated with septal em (r=0.40, p<0.03), SBP (r=0.35, p<0.07), fasting glucose (r=0.40, p<0.03) and serum TG (r=0.50, p<0.007). HRR at 6- and 7min were also associated with septal em (r=0.46, p<0.001 and r=-0.42, p<0.03, respectively). Conclusion Lower HRR following maximal exercise may predict diastolic dysfunction in HIV+ subjects and may be a useful screening tool in the detection of diastolic dysfunction in HIV+. Supported by the NIH.