Dataset Information

Heart Rate Recovery 10 Seconds After Cessation of Exercise Predicts Death.

ABSTRACT:

Background

Heart rate recovery (HRR) is commonly defined as the decrease of heart rate at 1 minute after cessation of exercise and is an important predictor of all-cause mortality and death associated with coronary artery disease. However, HRR at earlier time intervals after cessation has not been well evaluated and might better reflect PNS reactivation. We hypothesize that early HRR indices within the first minute is better associated with all-cause and coronary artery disease mortality compared with HRR at 1 minute.

Methods and results

The prognostic value of HRR at 10, 20, 30, 40, and 50 seconds after cessation of exercise was investigated in 40 727 selected UK Biobank participants (mean age 56 years, 45% male) free from cardiovascular disease. During a median follow-up period of 6 years, 536 participants died (including 39 of coronary artery disease). In multivariable analyses, including adjustments for aerobic exercise capacity, cardiovascular risk factors, and factors associated with mortality in general, only HRR at 10 seconds remained predictive of both all-cause and coronary artery disease mortality. Effects of HRR were larger and more significant when measured early after exercise cessation. Moreover, the association of change in heart rate between 10 seconds and 1 minute after exercise cessation with mortality was dependent on HRR at 10 seconds.

Conclusions

We provide evidence that decreased HRR at 10 seconds after cessation of exercise is a superior predictor of outcome compared with HRR at later time intervals. This observation might have important implications for the future reporting and interpretation of exercise tests.

SUBMITTER: van de Vegte YJ

PROVIDER: S-EPMC6015434 | biostudies-literature | 2018 Apr

REPOSITORIES: biostudies-literature

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Publications

Heart Rate Recovery 10 Seconds After Cessation of Exercise Predicts Death.

van de Vegte Yordi J YJ van der Harst Pim P Verweij Niek N

Journal of the American Heart Association 20180405 8

<h4>Background</h4>Heart rate recovery (HRR) is commonly defined as the decrease of heart rate at 1 minute after cessation of exercise and is an important predictor of all-cause mortality and death associated with coronary artery disease. However, HRR at earlier time intervals after cessation has not been well evaluated and might better reflect PNS reactivation. We hypothesize that early HRR indices within the first minute is better associated with all-cause and coronary artery disease mortality ...[more]

PMID: 29622586

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Project description:This study aimed to examine the agreement and acceptance of ultra-short-term heart rate (HR) variability (HRVUST) measures during post-exercise recovery in college football players. Twenty-five male college football players (age: 19.80 ± 1.08 years) from the first division of national university championship voluntarily participated in the study. The participants completed both a repeated sprint ability test (RSA) and a Yo-Yo intermittent recovery test level 1 (YYIR1) in a randomized order and separated by 7 days. Electrocardiographic signals (ECG) were recorded in a supine position 10 min before and 30 min after the exercise protocols. The HR and HRV data were analyzed in the time segments of baseline 5~10 min (Baseline), post-exercise 0~5 min (Post 1), post-exercise 5~10 min (Post 2), and post-exercise 25~30 min (Post 3). The natural logarithm of the standard deviation of normal-to-normal intervals (LnSDNN), root mean square of successive normal-to-normal interval differences (LnRMSSD), and LnSDNN:LnRMSSD ratio was compared in the 1st min HRVUST and 5-min criterion (HRVcriterion) of each time segment. The correlation of time-domain HRV variables to 5-min natural logarithm of low frequency power (LnLF) and high frequency power (LnHF), and LF:HF ratio were calculated. The results showed that the HRVUST of LnSDNN, LnRMSSD, and LnSDNN:LnRMSSD ratio showed trivial to small effect sizes (ES) (-0.00~0.49), very large and nearly perfect interclass correlation coefficients (ICC) (0.74~0.95), and relatively small values of bias (RSA: 0.01~-0.12; YYIR1: -0.01~-0.16) to the HRVcriterion in both exercise protocols. In addition, the HRVUST of LnLF, LnHF, and LnLF:LnHF showed trivial to small ES (-0.04~-0.54), small to large ICC (-0.02~0.68), and relatively small values of bias (RSA: -0.02~0.65; YYIR1: 0.03~-0.23) to the HRVcriterion in both exercise protocols. Lastly, the 1-min LnSDNN:LnRMSSD ratio was significantly correlated to the 5-min LnLF:LnHF ratio with moderate~high level (r = 0.43~0.72; p < 0.05) during 30-min post-exercise recovery. The post-exercise 1-min HRV assessment in LnSDNN, LnRMSSD, and LnSDNN:LnRMSSD ratio was acceptable and accurate in the RSA and YYIR1 tests, compared to the 5-min time segment of measurement. The moderate to high correlation coefficient of the HRVUST LnSDNN:LnRMSSD ratio to the HRVcriterion LnLF:LnHF ratio indicated the capacity to facilitate the post-exercise shortening duration of HRV measurement after maximal anaerobic or aerobic shuttle running. Using ultra-short-term record of LnSDNN:LnRMSSD ratio as a surrogate for standard measure of LnLF:LnHF ratio after short-term bouts of maximal intensity field-based shuttle running is warranted.

Project description:BackgroundThe BODE index, consisting of body mass index (B), airflow obstruction (O), dyspnea score (D), and exercise capacity (E), can predict outcomes in COPD. However, when spirometry was restricted to prevent cross-infection such as COVID-19 pandemic, a modified index would be needed. Because cardiovascular dysfunction is associated with poor clinical outcomes in COPD, we conducted a novel BHDE-index by replacing spirometry with post-exercise heart rate recovery (HRR, H) and evaluated its predictive performance in this observational study.MethodsFrom January 2019 to December 2019, enrolled patients were analyzed as a derivation cohort for the setup of the model. This model was verified in another group of patients generated between January 2020 and December 2020, as the validation cohort. The post exercise HRR was defined as the difference of heart rate immediately after and 1 min after test cessation.ResultsA total of 447 patients with COPD were enrolled. Patients with abnormal HRR were older, with more severe airway obstruction, severe airway symptoms, faster resting heart rate, shorter 6-min walk distance and higher frequency of severe acute exacerbation in previous one year. The prediction performance of the BHDE-index for one-year severe COPD exacerbation was similar to that of the BODE-index in both the derivation and validation groups [area under the receiver operating characteristic curve (AUROC) 0.76 vs. 0.75, p = 0.369; AUROC 0.74 vs. 0.79, p = 0.05]. The prediction performance for 1 year mortality was also similar between BHDE-index and BODE-index in both cohorts [AUROC 0.80 vs. 0.77, p = 0.564; 0.76 vs. 0.70, p = 0.234]. Univariate and multivariate analyses also showed that the BHDE-index was an independent and important predictor of annual severe COPD exacerbation in the derivation and validation cohorts.ConclusionsThe BHDE-index is a good and easy-to-perform prediction model for the risk of severe acute exacerbation and 1-year mortality in COPD wherever spirometry results are unavailable.

Dataset Information

Heart Rate Recovery 10 Seconds After Cessation of Exercise Predicts Death.

Background

Methods and results

Conclusions

Publications

Heart Rate Recovery 10 Seconds After Cessation of Exercise Predicts Death.

Similar Datasets

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