Heart Rate Recovery Values Research Articles

Long-term prognostic value of heart rate recovery in patients with left bundle branch block without inducible ischemia and without known coronary artery disease

Abstract Background Heart rate recovery (HRR) has been shown to predict cardiovascular and all-­cause morbidity and mortality. Left bundle branch block (LBBB) is often associated with significant heart disease and is often the result of underlying coronary artery disease (CAD), myocardial injury, strain or hypertrophy. However, there are insufficient data on the prognostic value of HRR in patients with LBBB without inducible ischemia and without known CAD. Aim The aim of this study was to determine the long-term prognostic value of HRR in patients with LBBB without inducible ischemia and without known CAD. Methods This retrospective study included 182 patients (64, 35.2% male gender, average age 63 ± 10 years) with LBBB and without known CAD who were referred to the SECHO test for chest pain. All the patients had negative SECHO test according the Bruce protocol. Risk factors for CAD (diabetes, smoking, hypertension, high cholesterol and positive family history of CAD), functional capacity (Metabolic Equivalents - METs) and heart rate recovery (HRR) were recorded in all patients. HRR was calculated as the difference between heart rate at the peak stress and heart rate in the first minute of rest. Slow HRR was defined as ≤18 beats/min. Median follow up of the patients was 102.5 months (IQR 68-146 months) for the occurrence of MACE (all-cause mortality, non-fatal myocardial infarction (MI), coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI)). Results Overall, 16pts (8.8%) had slow HRR. During the follow-up period 34 out of 182 patients (18.7%) had an adverse event (16 deaths, 10 non-fatal MI, 1 CABG and 7 PCI). Using the Cox regression analysis, univariate predictors of MACE were age (B=0.050, HR 1.051 [95% CI 1.011-1.093], p=0.012), hypertension (B=-1.219, HR 3.385 [95% CI 1.071-10.699], p=0.038), MET (B=-0.183, HR 0.833 [95% CI 0.706-0.982], p=0.030), diabetes (B=0.981, HR 2.667 [95% CI 1.267-5.612], p=0.010) and slow HRR (B=1.171, HR 3.225 [95% CI 1.307-7.959], p=0.011). However, in the multivariate analysis only slow HRR remained the independent predictor of MACE (B=0.974, HR 2.648 [95% CI 0.980-7.151], p=0.048). Using the Kaplan-Meier survival curve we see that the patients with slow HRR had much shorter event-free time compared to the patients with normal HRR (106.9 ± 14.9 months vs 157.9 ± 24 months, Log Rank 7.227, p=0.007) (Figure 1.). Conclusion Slow HRR is an independent long-term predictor of adverse events in patients with left bundle branch block without inducible ischemia and without known coronary artery disease.Kaplan-Meier survival curve for the MACE

The incremental significance of heart rate recovery as a predictor during exercise-stress myocardial perfusion SPECT imaging in individuals with suspected coronary artery disease.

Major adverse cardiac events (MACE) are more likely to occur when abnormal heart rate recovery (HRR). This study aimed to assess the incremental predictive significance of HRR over exercise stress myocardial perfusion single-photon emission computed tomography (MPS) results for MACE in individuals with suspected coronary artery disease (CAD). Between January 2014 and December 2017, we continually gathered data on 595 patients with suspected CAD who received cycling exercise stress MPS. HRR at 1, 2, 3, and 4 min were used as study variables to obtain the optimal cut-off values of HRR for MACE. The difference between the peak heart rate achieved during exercise and the heart rate at 1, 2, 3, and 4 min was used to calculate the HRR, as shown in HRR3. Heart rate variations between two locations in time, such as HRR2 min-1 min, were used to establish the slope of HRR. All patients were followed for a minimum of 4 years, with MACE as the follow-up goal. The associations between HRR and MACE were assessed using Cox proportional hazards analyses. Patients with MACE were older (P = 0.001), and they also had higher rates of hypertension, dyslipidemia, diabetes, abnormal MPS findings (SSS ≥ 5%), medication history (all P < 0.001), and lower HRR values (all P < 0.01). Patients with and without MACE did not significantly vary in their HRR4 min-3 min. The optimal cut-off of HRR1, 2, and 3 combined with SSS can stratify the risk of MACE in people with suspected CAD (all P < 0.001). HRR 1, 2, and 3 and its slope were linked to MACE in multivariate analysis, where HRR3 was the most significant risk predictor. With a global X2 increase from 101 to 126 (P < 0.0001), HRR3 demonstrated the greatest improvement in the model's predictive capacity, incorporating clinical data and MPS outcomes. HRR at 3 min has a more excellent incremental prognostic value for predicting MACE in patients with suspected CAD following cycling exercise stress MPS. Therefore, incorporating HRR at 3 min into known predictive models may further improve the risk stratification of the patients.

Evaluation of Heart Rate Recovery in Obese Children and Adolescents With Prehypertension.

Heart rate recovery (HRR), a noninvasive assessment of autonomic nervous function, is widely studied in adults with hypertension or prehypertension. This study aimed to evaluate whether HRR was independently associated with prehypertension in obese children. A total of 326 obese children aged 7 to 16 years were divided into 2 groups: prehypertension group and normal blood pressure (BP) group (control group). Anthropometric indexes, physical activity (PA) information, biochemical parameters, and HRR were collected. Multiple logistic regression analysis showed that body mass index (BMI) (odds ratio [OR] = 1.116; P < .05), waist-to-hip ratio (WHR) (OR = 1.258; P < .05), homeostasis model assessment (HOMA-IR) (OR = 1.087; P < .01), diastolic blood pressure (DBP) (OR = 1.304; P < .01), and HRR values (OR = 0.892; P < .05) were independent risk factors of prehypertension in obese children. Our findings demonstrated decreased HRR was closely associated with prehypertension in obese children, which indicated studying the role of sympathetic/parasympathetic imbalance might be helpful to explore the underlying mechanism.

EXERCISE IMPROVES HEART RATE RECOVERY GREATER THAN STANDARD CARE IN TYPE 2 DIABETES

https://youtu.be/HRw1f_DoX-Q INTRODUCTION An attenuated heart rate recovery (HRR) immediately after exercise is considered an index of autonomic imbalance and is a predictor of all cause mortality in patients with type 2 diabetes (T2D). Because autonomic dysfunction in T2D patients has shown to be reversible with glycemic control, weight loss, and fitness gain, we investigated the effect of a 12 week aerobic exercise (AE) intervention compared to standard care on HRR in patients with T2D. METHODS T2D patients (n=32) were randomized to a 12-week AE intervention (n=19) or standard of care (n=13). The AE intervention consisted of supervised exercise training for 1h/day 5/wk for 12 weeks at 80% VO2peak. All subjects completed body composition analysis (DEXA), oral glucose tolerance test (OGTT), and maximal exercise testing before and after the study period. HRR was measured every minute for 10 minutes after cessation of maximal exercise testing. RESULTS Baseline HRR 1-minute values were negatively associated with ASCVD Risk (rho = 0.623; p = 0.002) and positively associated with VO2peak (rho = 0.361; p = 0.042). Body weight was unchanged in both control (p = 0.989) and AE group (p = 0.248) after the study period. Following AE training intervention, VO2peak increased by 7.4 ± 1.9% (p &amp;lt; 0.001), glucose metabolism, as measured by OGTT area under the curve (AUC), improved by 11.6 ± 6.0% (p = 0.040), and HRR 1-minute increased by 10.4 ± 6.1% (p = 0.234). The control group showed no significant changes as VO2peak increased by 0.7 ± 2.6% (p = 0.826), AUC improved by 3.1 ± 3.5% (p = 0.585), and HRR 1-minute increased 3.9 ± 9.0% (p = 0.915). Baseline HRR predicted change in HRR after the study period in the control group (rho = −0.817; p = 0.002) but not in the AE group (rho = −0.054, p = 0.860). Upon controlling for baseline HRR, AE group possessed a significantly higher post intervention HRR 1-minute value than control by 28.5% (p = 0.036). We found the AE group also had higher HRR values than control during the post-intervention 10-minute recovery resulting in a main effect of group (p &amp;lt; 0.001). CONCLUSIONS T2D patients with higher HRR, only receiving standard of care, are more susceptible to chronic detriments in HRR indicative of gradual autonomic function loss. To our knowledge these are the first data showing regular moderate-vigorous intensity exercise, which improved glycemic control and fitness gain independent of weight loss, outperforms standard of care alone for greater HRR.

Does long-term exposure to air pollution suppress parasympathetic reactivation after incremental exercise among healthy males and females?

Purpose As consequences of industrial processes, air pollution has led to increased cardiovascular diseases resulting in mortality. However, there are few pieces of evidence expressing physical fitness and gender impacts in such environments. Regarding long-term exposure to air pollution, this study aimed to determine the effect of physical fitness on post-exercise cardiac parasympathetic reactivation among healthy males and females. Methods 120 individuals (46 ± 5 years) participated and were categorized into two main groups (n = 60; EG, CG); (1) The experimental group included individuals living in an air-polluted environment; (2) The control group included the citizens of a clean air region; and two physical fitness status subgroups (n = 30; active vs. sedentary) across both sexes. The heart rate (HR) changes at different timing after performing an incremental exercise, and T30 were calculated as metrics of cardiac parasympathetic reactivation. Results The heart rate recovery values were substantially lower in EG in comparison to CG (p < 0.001) at different timing, while, T30 was significantly greater in residents of the air-polluted city compared to CG (p < 0.001). As for heart rate recovery at the 5th minute, the values were significantly lower in the steady-female group in comparison to the active females living in the air-polluted city (p < 0.01). Conclusion Based on our findings, although physical fitness modifies the adverse impacts of long-term exposure to air pollution on post‐exercise cardio-parasympathetic reactivation, it appears to parallel the acute/intermediate recovery of the thermoregulatory and vascular systems, among both sexes, it does not prevent them.

PROFIL HEART RATE RECOVERY SETELAH EXERCISE MAXIMAL ATLET PELAJAR SIDOARJO PADA CABANG OLAHRAGA DINAMIS

The main objective of this study was to determine the profile of Heart Rate Recovery (HRR) after conducting Exercise Maximal (EM) using speed tests, namely sprints, quantitative research methods while the research sample was 86 male student athletes consisting of 5 athletic athletes, 17 volleyball athletes, 22 hockey athletes, 15 roller skating athletes, 15 beach volleyball athletes and 3 court tennis athletes. the first data collection participants performed a sprint speed test of 30m. Furthermore, HRR is measured using the Polar type H10 tool using the Polar Team monitor system. Furthermore, HRR is recorded at minutes 1,2,3,4, and 5 shortly after doing maximum exercise. Furthermore, by using the paired t-test and friedman's test to see the significance of the difference in values every minute. Furthermore, to get a poor heart rate recovery profile, a calculation of ΔHRR with a maximum heart rate (HR) is carried out. the results showed a significant difference in HRR values of 1, 2, and 3 χ2F (2) = 170.02, p&lt;0.001 using friedman's test. significant differences were also found in hrr values 4 and 5 using paired sample t-test HRR 4 (Mean=104.07, SD=8.838) and HRR 5 (Mean=95.35, SD=7.232) under conditions; t(85)=15.618, p=0.000. furthermore, in order for the difference in HRR to be meaningful, further tests were carried out by looking for Δ HRR1,2,3,4, and 5 with HRmaximal and obtained the values of ΔHRR 1 19.18±6.6, then in order Δ HRR 2: 29.45±7.10, Δ HRR 3: 38.06±6.88, Δ HRR 4:43.72±5.54, and ΔHRR 5:48.44±4.67. In this study, it can be proven that the HRR profile in student athletes can be used as an indicator of athletes' readiness to receive and participate in training programs.

Investigation of the Cardiac Autonomic Functions in Patients with Essential Tremor

Introduction: Essential tremor is a neurological disorder that causes involuntary shaking. The aim of this study was to examine cardiac autonomic functions in patients diagnosed with essential tremor, as previous studies have differed in their findings regarding whether cardiac autonomic functions are affected in essential tremor patients. Patients and Methods: The study included 32 patients diagnosed with essential tremor and 26 individuals without any diseases as the control group. Consensus criteria were used for the diagnosis of essential tremor. A clinical rating scale was utilized to measure the characteristics and degree of essential tremor. Based on this scale, patients were classified as having a mild, moderate, marked, or severe disability. An exercise treadmill test was performed in both the tremor and control groups. Chronotropic index values were used to evaluate the sympathetic system, and resting heart rate index values were calculated to evaluate the parasympathetic system. Heart rate recovery values were calculated at one, two, three, four, and five minutes after the exercise treadmill test. Results: The descriptive characteristics of the tremor and control groups were similar. The Chronotropic index values were statistically different between the tremor and control groups, as they were significantly decreased in the tremor group. This was evaluated as sympathetic incompetence. The resting heart rate index values did not differ significantly between the tremor and control groups at minutes one or two, but they were significantly higher in the tremor group at minutes three, four, and five. The parasympathetic activity was found to be insufficient in the later period. Conclusion: The findings suggest that cardiac autonomic functions may be affected in patients with essential tremor.

Heart rate recovery and risk of cardiovascular disease and all-cause mortality: a systematic review of prospective cohort studies

Abstract Funding Acknowledgements Type of funding sources: None. Purpose An attenuated decrease of heart rate recovery (HRR) immediately after exercise is an indicator of autonomic dysfunction and has been linked with a higher risk of cardiovascular disease and all-cause mortality in both healthy and clinical population. However, the evidence regarding its potential prognostic value varies across studies making its implementation in clinical practice for risk assessment difficult. The purpose of the present systematic review is therefore, to investigate the predictive value of heart rate recovery in CVD disease and all-cause mortality, in an evidenced-based manner to encourage its incorporation in clinical practice Methods and Results A systematic review was performed through a comprehensive search on PubMed that focused only on prospective cohort studies. Of the studies retrieved, a total of 13 eligible articles were included in this systematic review with nine of them enrolling 37 457 participants and 709 CVD cases for cardiovascular events, and 12 comprising 45 905 participants and 4 301 deaths for all-cause mortality.The study quality of the included studies was rated moderate to high (4-8) with high heterogeneity (I² = 0.0001). Results revealed no statistically significant difference in HRR for patients with and without cardiovascular events M=-2672.16, at 95% CI [-7341.6,1997.32] ; P-value = .234 as well as for people who died and those who did not M= -3141.667, at 95% CI [-7627.448,1344.144], P-value = .151. Also, the association between CVD and mortality was presented statistically significant, Chi-Square = p&amp;lt;0.0001 while a further analyses of heart rate recovery revealed that when distinguished between low and high, it was found to have a strong positive association with all-cause mortality, Chi-Square = p&amp;lt;0.0001. Conclusion The current systematic review findings indicated that a low HRR is directly linked with greater all-cause mortality risk. Also, given the strong association found between CVD and mortality, the study further supported that even though indirectly, a low HRR is also associated with an increased risk of cardiovascular events, supporting the notion that HRR has a prognostic value and could be used in clinical practice.

Markers of Cardiac Autonomic Function During Consecutive Day Peak Exercise Tests in People With Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) have been shown to exhibit altered ventilatory characteristics on the second of two progressive maximal cardiopulmonary exercise tests (CPET) performed on consecutive days. However, maximal exercise can exacerbate symptoms for ME/CFS patients and cause significant post-exertional malaise. Assessment of heart rate (HR) parameters known to track post-exertional fatigue may represent more effective physiological markers of the condition and could potentially negate the need for maximal exercise testing. Sixteen ME/CFS patients and 10 healthy controls underwent a sub-maximal warm-up followed by CPET on two consecutive days. Ventilation, ratings of perceived exertion, work rate (WR) and HR parameters were assessed throughout on both days. During sub-maximal warm-up, a time effect was identified for the ratio of low frequency to high frequency power of HR variability (p=0.02) during sub-maximal warm-up, and for HR at ventilatory threshold (p=0.03), with both being higher on Day Two of testing. A significant group (p<0.01) effect was identified for a lower post-exercise HR recovery (HRR) in ME/CFS patients. Receiver operator characteristic curve analysis of HRR revealed an area under the curve of 74.8% (p=0.02) on Day One of testing, with a HRR of 34.5bpm maximising sensitivity (63%) and specificity (40%) suggesting while HRR values are altered in ME/CFS patients, low sensitivity and specificity limit its potential usefulness as a biomarker of the condition.

Association between Circulating Adiponectin and Heart Rate Recovery in Women with Polycystic Ovarian Syndrome

ABSTRACT Context Adiponectin (APN) is reported to be correlated closely with autonomic nervous function in different clinical settings. Heart rate recovery (HRR) is a noninvasive and readily obtainable indicator, which reflects the coordinated interplay between parasympathetic reactivation and sympathetic withdrawal. Objective This study aimed to investigate the relationship between serum APN and HRR in polycystic ovarian syndrome (PCOS) women. Design Eighty-nine PCOS women were enrolled and divided into two groups. Women with HRR values slower than 12 beats were defined as Blunted HRR Group. APN levels were compared between Blunted HRR Group and Normal HRR Group. Multivariate logistic regression analysis and multiple linear regression analysis were performed to determine which clinical variables were independently associated with HRR and APN levels, respectively. Results Twenty-three women were categorized into Blunted HRR Group, in which APN level was significantly lower than Normal HRR Group. Age, body mass index, hypertension, and APN were independent factors of attenuated HRR in PCOS women. Meanwhile, multiple linear regression analysis showed age, dyslipidemia, and homeostasis model assessment-insulin resistance (HOMA-IR) were closely associated with APN levels in PCOS women. Conclusions Our findings suggested that decreased APN concentration was closely associated with HRR blunt in PCOS women. Further studies are needed to explore the underlying interactions between APN and autonomic nervous function.

The prognostic role of heart rate recovery after exercise and metabolic syndrome in IgA nephropathy

BackgroundCardiovascular (CV) morbidity and mortality are higher in chronic kidney disease (CKD) than in the general population. Reduced heart rate recovery (HRR) is an independent risk factor for CV disease. The aim of the study was to determine the prognostic role of HRR in a homogenous group of CKD patients.MethodsOne hundred and twenty-five IgA nephropathy patients (82 male, 43 female, age 54.7 ± 13 years) with CKD stage 1–4 were investigated and followed for average 70 months. We performed a graded exercise treadmill stress test. HRR was derived from the difference of the peak heart rate and the heart rate at 1 min after exercise. Patients were divided into two groups by the mean HRR value (22.9 beats/min). The composite (CV and renal) endpoints included all-cause mortality and any CV event such as stroke, myocardial infarction, revascularisation (CV) and end-stage renal disease, renal replacement therapy (renal).ResultsPatients with reduced HRR (< 23 bpm) had significantly more end point events (22/62 patients vs. 9/53 patients, p = 0.013) compared to the higher HRR (≥23 bpm). Of the secondary the endpoints (CV or renal separately) rate of the renal endpoint was significantly higher in the lower HRR group (p = 0.029), while there was no significant difference in the CV endpoint between the two HRR groups (p = 0.285). Independent predictors of survival were eGFR and diabetes mellitus by using Cox regression analysis. Kaplan-Meier curves showed significant differences in metabolic syndrome and non-metabolic syndrome when examined at the combined endpoints (cardiovascular and renal) or at each endpoint separately. The primary endpoint rate was increased significantly with the increased number of metabolic syndrome component (Met.sy. comp. 0 vs. Met. sy. comp. 2+, primary endpoints, p = 0.012).ConclusionOur results showed that reduced HRR measured by treadmill exercise test has a predictive value for the prognosis of IgA nephropathy. The presence of metabolic syndrome may worsen the prognosis of IgA nephropathy.

Correlation of heart rate recovery and heart rate variability with atrial fibrillation progression.

ObjectiveTo examine the combination of heart rate recovery (HRR) and heart rate variability (HRV) in predicting atrial fibrillation (AF) progression.MethodsData from patients with a first detected episode of AF who underwent treadmill exercise testing and 24-h Holter electrocardiography were retrospectively analysed. Autonomic dysfunction was verified using HRR values. Sympathetic and parasympathetic modulation was analysed by HRV. AF progression was defined as transition from the first detected paroxysmal episode to persistent/permanent AF.ResultsOf 306 patients, mean LF/HF ratio and HRR did not differ significantly by AF progression regardless of age (< or ≥65 years). However, when the LF/HF ratio was divided into tertiles, in patients aged <65 years, the mid LF/HF (1.60–2.40) ratio was significantly associated with lower AF progression rates and longer maintenance of normal sinus rhythm. For patients aged <65 years, less metabolic equivalents were related to higher AF progression rates. For patients aged ≥65 years, a low HRR was associated with high AF progression rates.ConclusionIn relatively younger age, high physical capacity and balanced autonomic nervous system regulation are important predictors of AF progression. Evaluation of autonomic function assessed by age could predict AF progression.

Heart rate recovery after exercise and long-term prognosis in Algerian patients with coronary artery disease

The long-term prognostic value of heart rate recovery (HRR) has been incompletely documented in patients with coronary artery disease (CAD). We sought to confirm the prognostic value of HRR in Algerian cohort with stable CAD. We identified 720 patients with baseline exercise stress testing data. HRR was measured at 3 minutes post exercise during a passive recovery. Clinical outcomes were evaluated according to HRR in both threshold and continuous models. Median long-term follow-up was 3.7 years. HRR < 45 beats per minute (Bpm) most appropriately differentiated non survivors from survivors and was associated with an increased risk of all-cause death (adjusted hazard ratio = 1.17; P = 0.001). Increasing HRR was associated with a lower risk of all-cause (adjusted hazard ratio = 0.93 per 10 Bpm;) and cardiovascular (CV) mortality (adjusted hazard ratio = 0.94 per 10 Bpm;). HRR at 3 minutes independently predicts long-term all cause and CV mortality in patients with stable CAD. Measurement of HRR at 3 minutes during passive recovery can be used as a complementary tool to identify patients with a higher total and CV risk.

Influence of a Training Academy on the Parasympathetic Nervous System Reactivation of Firefighter Recruits-An Observational Cohort Study.

Sudden cardiac death (SCD) is the leading type of line-of-duty death among firefighters. An inability to restore parasympathetic nervous system (PSNS) control after activity is associated with SCD. Post-exercise heart rate recovery (HRR) provides unique insight into reactivation of the PSNS. Thus, the purpose of this study was to examine longitudinal changes in HRR responses of 25 male firefighter recruits. HR data were collected after submaximal exercise at week 1 (W1), week 6 (W6), and week 15 (W15) of their training at an academy. Percent maximal heart rate (%MHR) measures were computed at each HRR time point (%MHR0, %MHR15, %MHR30, %MHR45, %MHR60, %MHR120, %MHR180) and absolute HRR values were calculated at 30 s (ΔHRR30), 60 s (ΔHRR60), 120 s (ΔHRR120), and 180 s (ΔHRR180). After controlling for age and percent body fat, there was no statistically significant interaction between Week × HRR (p = 0.730), and there were no changes in ΔHRR30, ΔHRR60, and ΔHRR120, and ΔHRR180 indices across time. However, %MHR at W6 and W15 was significantly lower than %MHR at W1 at every HRR time point (ps < 0.001). Therefore, although the firefighter recruit training academy elicited positive training adaptations, changes in PSNS reactivation after submaximal activity were not identified.

Higher omega-3 index is associated with more rapid heart rate recovery in healthy men and women

BackgroundPrevious studies have suggested that omega-3 polyunsaturated fatty acids (n-3 PUFA) can favorably influence cardiac autonomic tone. However, data regarding n-3 PUFA status and heart rate recovery (HRR) in healthy adults are sparse. PurposeTo examine the association between n-3 PUFA status and HRR. MethodsParticipants included 13,912 patients who underwent a comprehensive examination at the Cooper Clinic, Dallas TX. Fitness was determined from a maximal exercise test. HRR was calculated by subtracting the heart rate at 1, 3, and 5 min of an active recovery period from the maximal heart rate. Participants were categorized as having a low (<4%), normal (4–8%) or optimal (>8%) Omega-3 Index (O3I) (i.e., erythrocyte levels of eicosapentaenoic and docosahexaenoic acids). Multiple linear regression was used to model the association between O3I and HRR adjusting for age, maximal METs, body mass index, and smoking by sex. ResultsHigher categories of O3I were associated with greater HRR at 1 min (men: 23.7, 23.9, 24.6 beats/min; women: 23.9, 24.6, 25.9 and 3 min (men: 52.4, 52.9, 53.6 beats/min; women: 51.9, 53.4, 54.6), p trend <0.01 for all. Corresponding HRR at 5 min were (men: 60.0, 60.2, 60.7 beats/min, p trend=0.09; women: 59.4, 60.8, 61.6, p trend <0.001). The HRR gradients across O3I categories were steeper in women than men at 1, 3, and 5 min (p<0.03 for all sex x O3I category interactions with HRR). ConclusionsA direct relationship between HRR and O3I values was observed in both men and women, with a steeper gradient in women. These findings suggest a potential cardioprotective mechanism for n-3 PUFA.

The alpha-melanocyte stimulating hormone is related to heart rate during exercise recovery

Alpha-melanocyte-stimulating hormone (alpha-MSH) is a part of the hormonal stress system with proven cardiovascular effects. Heart rate recovery (HRR) following exercise is strongly correlated to overall fitness and future adverse cardiovascular events. The current study examined the predictive value of alpha-MSH for HRR following exercise testing.Cardiopulmonary exercise testing (CPET) on a treadmill was used to measure HR and oxygen consumption (V̇O2) in 16 elite male wrestlers (W), 21 water polo player (WP) and 20 sedentary subjects (C) matched for age. Plasma levels of alpha-MSH were measured by radioimmunoassay technique in four phases of CPET: 1) 10 min pre-CPET at rest; 2) at the initation of CPET; 3) at peak CPET; and 4) at the third minute of recovery. The WP group had significantly higher HRR compared to than W and C groups, who did not have significantly different values. Significant difference in alpha-MSH measurements and patterns during CPET between groups was not observed (p > 0.05). When combining all three groups, we observed a significant correlation between V̇O2 recovery and alpha-MSH recovery/peak (r = -0.3, p = 0.022). HRR and ΔHRR/peak significantly correlated with alpha-MSH at all four measurment points (r = -0.4; p < 0.01 for all). On multiple regression analysis, which included anthropometric and hormonal measures, the best independent predictor of HRR and ΔHRR/peak was alpha-MSH during recovery (B = -1.0, -0.5; SE = 0.3, 0.1; CI = -1.5 to -0.4, -0.7 to -0.2; p = 0.001 respectively). In conclusion, alpha-MSH measured during exercise recovery holds predictive value for HRR and ΔHRR/peak, suggesting a contributing role to integrative regulation of overall cardiopulmonary performance. Condensed abstractPresent study examined the predictive value of alpha-melanocyte stimulating hormone (alpha-MSH) for heart rate recovery (HRR) in elite male wrestlers, water polo players and sedentary subjects matched for age. Alpha-MSH measured during exercise recovery holds predictive value for HRR and ΔHRR/peak, suggesting a contributing role to integrative regulation of overall cardiopulmonary performance.

Attenuated heart rate recovery in children and adolescents with obstructive sleep apnea syndrome.

Autonomic dysfunction is a key trait in the development of obstructive sleep apnea syndrome (OSAS) in adults. However, few similar studies focused on children and adolescents. We investigated if there was any association between heart rate recovery (HRR) and the severity of OSAS in children and adolescents. A total of 161 subjects were included: 87 healthy controls, 35 mild OSAS patients (M-OSAS) and 39 moderate-severe OSAS (M-S-OSAS) patients. Clinical parameters, cardiopulmonary exercise test (CPET) indexes including HRR and polysomnographic records including apnea-hypopnea index (AHI) were compared among the three groups. Pearson correlation analysis and multivariable linear regression analysis were used to detect the relationship between HRR and polysomnographic parameters. HRR values in either the OSAS group were lower than those of the control group, and the values in the M-S OSAS group were even lower than those of the M-OSAS group (P < 0.05). Correlation analysis showed that HRR was inversely correlated with AHI (r = -0.190, P < 0.01). Moreover, multivariable linear regression analyses showed the association between HRR and AHI was significant (β = 0.174, P < 0.01). HRR was closely associated with OSAS severity, which suggested that HRR might be a promising index for risk stratification and clinical management in children and adolescents with OSAS. Heart rate recovery (HRR), a noninvasive and reliable index of automatic nervous system, is closely associated with the severity of obstructive sleep apnea syndrome (OSAS) in children and adolescents. To our knowledge, our study was the first study in China focusing on evaluating the role of HRR in children with OSAS. We found HRR was closely associated with OSAS severity in children and adolescents, and it suggested that HRR might be a promising index for risk stratification and clinical management in children and adolescents with OSAS.

Determinants and Prognostic Value of Heart rate Recovery in Short-term outcome of percutaneous coronary intervention in Patients with and without Type 2 Diabetes

Determinants and Prognostic Value of Heart rate Recovery in Short-term outcome of percutaneous coronary intervention in Patients with and without Type 2 Diabetes

Heart rate recovery in normal and obese males with and without parental history of cardiovascular disease.

Background:Parental history of cardiovascular disease (CVD) and obesity is associated with delayed parasympathetic nervous system reactivation after exercise. Heart rate recovery (HRRe) after a minute of exercise is inversely related to cardiovascular events.Aim:To determine the effect of body mass index (BMI) and parental CVD history on HRRe in apparently healthy young Indian males.Method:The present cross-sectional experimental study involved 100 males, aged18–25 years. Subjects were divided into two equal groups based on the parental CVD history—(i) Parental CVD history present, and (ii) Parental CVD history absent. Each of these groups were further divided into two equal sub groups based on BMI—(a) BMI <23kg/m2, and (b) BMI ≥25 kg/m2. Participants exercised on the treadmill at variable speeds and grades to achieve their target HR (THR). THR was calculated by adding 60–90% HR-reserve (HRR) in their basal HR (BHR). HRR was calculated by subtracting maximal HR (MHR) from BHR. MHR was estimated by the formula: 208–0.7 × age. The HRRe was calculated by subtracting the immediate postexercise HR with the HR after a minute of rest postexercise. ANOVA with post-hoc Tukey was applied and a P value ≤0.05 was considered as statistically significant.Results:HRRe value was significantly lesser in subjects having a positive parental history of CVD than the subjects with no parental history of CVD, irrespective of BMI. Also, HRRe was inversely related to BMI.Conclusion:Not only obesity but also a family history of CVD impacts the recovery of HR after vigorous-intensity exercise.

The Relationship between the Amount of Epicardial Adipose Tissue Measured on Echocardiography and Decreased Heart Rate Recovery in Exercise Stress Test in Patients with Metabolic Syndrome

Introduction: In this study, the impact of the epicardial adipose tissue (EAT) thickness on the heart rate recovery (HRV) was investigated by comparing the HRV values in the second minute of the recovery phase of the exercise test applied to metabolic syndrome (MS) patients and the healthy control group. Materials and Methods: A total of 78 people, 30 of them healthy control group and 48 of them diagnosed with MS for the first time were included in the study which was carried out in a Uludag University’s Medical Faculty Hospital in Turkey. The study was designed prospectively. The EAT thickness measurement was performed and recorded for all individuals. All patients underwent a symptom-limited exercise test following the Bruce protocol. The relationship between known risk factors of coronary artery disease of the EAT thickness measured by echocardiography and decreased HRV index in the recovery phase in the exercise stress test was investigated. Results: Metabolic syndrome group was found out to have a significantly thicker EAT thickness (p