Abstract

Background and aimHigh heart rate is an independent predictor of total cancer incidence and all-cause mortality in patients with cancer. We aimed to evaluate the impact of resting heart rate on the recurrence of colorectal polyp, using long-term surveillance follow-up data of colorectal cancer survivors.MethodsThree hundred patients were selected from the colorectal cancer survivor cohort of Severance Hospital, Seoul, Korea. Resting heart rate, physical activity, and body composition analysis at the time of 5-year survival, and clinical data including colonoscopy surveillance results were collected for mean follow-up duration of 8 years.ResultsPatients with a high resting heart rate showed a significantly higher recurrence rate of advanced adenoma than those with a low resting heart rate (quartile 1, 45–66 beats per minute (b.p.m.); quartile 2, 67–73 b.p.m.; quartile 3, 74–80 b.p.m.; quartile 4, 81–120 b.p.m.; 3.8% vs. 7.9% vs. 10.0% vs. 14.7%, p for trend = 0.018). After adjustment for various risk factors, patients in the highest quartile of resting heart rate (≥ 81 b.p.m.) had a significantly higher risk of advanced adenoma recurrence (hazard ratio [HR]: 6.183, 95% confidence interval [CI]: 1.181–32.373, p = 0.031), compared to those in the lowest quartile (≤ 66 b.p.m.). In subgroup analysis, the association of resting heart rate with advanced adenoma recurrence appeared to be stronger among patients who had more than normal body fat mass or sedentary life style.ConclusionsElevated resting heart rate was independently associated with a higher rate of advanced adenoma recurrence in colorectal cancer survivors.

Highlights

  • Resting heart rate is a sensitive indicator of the autonomic nervous system

  • After adjustment for various risk factors, patients in the highest quartile of resting heart rate (! 81 b.p.m.) had a significantly higher risk of advanced adenoma recurrence, compared to those in the lowest quartile ( 66 b.p. m.)

  • The association of resting heart rate with advanced adenoma recurrence appeared to be stronger among patients who had more than normal body fat mass or sedentary life style

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Summary

Introduction

Resting heart rate is a sensitive indicator of the autonomic nervous system. An increase in the resting heart rate is caused by activation of sympathetic activity more than parasympathetic activity and/or decreased vagal tone. Resting heart rate can be influenced by lifestyle factors, such as psychological stress and physical activity [1,2]. Knowing that psychological stress and physical activity are closely associated with prognosis of cancer, high resting heart rate may be used as a prognostic factor for cancer recurrence. The relative risk (RR) of a 10-beats-per-minute (b.p.m.) increase in the resting heart rate for patients with cancer was 1.14 (95% confidence interval [CI]: 1.06–1.23, p < 0.0001), and the RR of a high versus low resting heart rate was 1.43 (95% CI: 1.12–1.82, p < 0.0001) [3]. We aimed to evaluate the impact of resting heart rate on the recurrence of colorectal polyp, using long-term surveillance follow-up data of colorectal cancer survivors

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