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Relation of heart rate recovery after exercise testing to coronary artery calcification
Authors:Sae Young Jae  Sudhir Kurl  Jari A. Laukkanen  Eun Sun Yoon  Yoon-Ho Choi  Bo Fernhall
Affiliation:1. Department of Sport Science, University of Seoul, Seoul, South Korea;2. Department of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland;3. Center for Health Promotion, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, South Korea;4. Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
Abstract:Background: We examined whether slow heart rate recovery (HRR) after exercise testing as an estimate of impaired autonomic function is related to coronary artery calcification (CAC), an emerging marker of coronary atherosclerosis.

Methods: We evaluated 2088 men who participated in a health-screening program that included measures of CAC and peak or symptom-limited cardiopulmonary exercise testing. HRR was calculated as the difference between peak heart rate (HR) during exercise testing and the HR at 2?min of recovery after peak exercise. We measured CAC using multidetector computed tomography to calculate the Agatston coronary artery calcium score. Advanced CAC was defined as a mean CAC >75th percentile for each age group.

Results: HRR was negatively correlated with CAC (r?=??.14, p?52 bpm). Each 1 bpm decrease in HRR was associated with 1% increase in advanced CAC after adjusting for potential confounders.

Conclusions: An attenuated HRR after exercise testing is associated with advanced CAC, independent of coronary risk factors and other related hemodynamic response.
  • KEY MESSAGES
  • Slow heart rate recovery (HRR) after maximal exercise testing, indicating decreased autonomic function, is associated with an increased risk of cardiovascular event and mortality.

  • Slow HRR has been linked with the occurrence of malignant ventricular arrhythmias, but it remains unclear whether slow HRR is associated with an increased risk of coronary artery calcification (CAC), an emerging marker of coronary atherosclerosis.

  • An attenuated HRR after exercise testing was associated with advanced CAC, independent of coronary risk factors and other potential hemodynamic confounder, supporting the hypothesis that slow HRR is related to the burden of atherosclerotic coronary artery disease.

Keywords:Coronary artery calcification  exercise testing  heart rate recovery
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