Email this article (Login required)
Email the author (Login required) CURRENT ISSUE: OCTOBER VOL 5-4
INDEXES
ISSN
The Relationship of Heart Rate Recovery Post Exercise Stress Test To Syntax Values In Patients With Stable Coronary Artery Disease
Abstract
Methods:This study is an analytic observational study with a retrospective cross sectional design. It was held in Saful anwar, Malang Hospital during January 2017–December 2019, including 366 patients. All patients underwent exercise stress test for CAD screening and coroner angiography. Those were divided into two groups, which included syntax score < 23 (n=148) and syntax score ≥ 23 (n= 218).
Result: Chi-square analysis was used to analyze the relationship correlation between HRR1, HRR2 and Syntax Score, and was used to compared between HRR1 (heart rate recovery first minutes), HRR2 (heart rate recovery second minute) and Syntax Score group. The confounding factor was adjusted with multivariate logistic regression analysis and AUC curve. There was a significant negatif correlation between abnormal HRR1 and HRR2 after exercise and Syntax score, with strong correlation (HRR1 ; OR = -2.11, p = 0.00 AUC :90,8%, HRR2 ; OR = -1,6, p = 0,48, AUC : 70,4%).
Conclusion: Abnormal first and second minutes of HRR after exercise stress test in stable CAD patient have a higher incidence of high Syntax Score (>1) than stable CAD patient with normal HRR.
Keywords: Coronary artery disease (CAD), Heart rate recovery (HRR), Syntax.
Keywords
Full Text:
PDFReferences
Tim Riskesdas 2018. Laporan Nasional Riskesdas 2018. Published online 2019.
Aneni E, Roberson LL, Shaharyar S, et al. Delayed Heart Rate Recovery is Strongly Associated With Early and Late-Stage Prehypertension During Exercise Stress Testing. American Journal of Hypertension. 2014;27(4):514-521. doi:10.1093/ajh/hpt173
Akgöz H, Gürkan U, Dayi ŞÜ, et al. The Relationship Between β-Receptor Sensitivity and Nocturnal Blood Pressure and Heart Rate Recovery in Normotensive People. Angiology. 2006;57(4):495-500. doi:10.1177/0003319706290624
Volkan Emren S, Gediz RB, Şenöz O, et al. Decreased heart rate recovery may predict a high SYNTAX score in patients with stable coronary artery disease. Bosn J of Basic Med Sci. 2019;19(1):109-115. doi:10.17305/bjbms.2019.3725
Akyuz A, Alpsoy S, Cayan Akkoyun D, Degirmenci H, Guler N. Heart rate recovery may predict the presence of coronary artery disease. Anadolu Kardiyol Derg. 2014;14(4):351-356. doi:10.5152/akd.2014.4824
Frenneaux MP. Autonomic changes in patients with heart failure and in post-myocardial infarction patients. Heart. 2004;90(11):1248-1255. doi:10.1136/hrt.2003.026146
WHO. The top 10 causes of death. Published November 25, 2021. https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death#
Antman EM, Loscalzo J. Ischemic Heart Disease. In: Jameson JL, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J, eds. Harrison’s Principles of Internal Medicine, 20e. McGraw-Hill Education; 2018. Accessed November 24, 2021. accessmedicine.mhmedical.com/content.aspx?aid=1160046856
Zipes DP. Influence of myocardial ischemia and infarction on autonomic innervation of heart. Circulation. 1990;82(4):1095-1105. doi:10.1161/01.CIR.82.4.1095
Reyes E, Underwood SR. Coronary anatomy and function: a story of Yin and Yang. Eur Heart J Cardiovasc Imaging. 2015;16(8):831-833. doi:10.1093/ehjci/jev138
Malagò R, Pezzato A, Barbiani C, et al. Coronary artery anatomy and variants. Pediatr Radiol. 2011;41(12):1505-1515. doi:10.1007/s00247-011-2218-9
Crowther MA. Pathogenesis of Atherosclerosis. Published online 2005:6.
Singh RB, Mengi SA, Xu YJ, Arneja AS, Dhalla NS. Pathogenesis of atherosclerosis: A multifactorial process. 2002;7(1):14.
Falk E. Pathogenesis of Atherosclerosis. Journal of the American College of Cardiology. 2006;47(8):C7-C12. doi:10.1016/j.jacc.2005.09.068
Minelli S, Minelli P, Montinari MR. Reflections on Atherosclerosis: Lesson from the Past and Future Research Directions. JMDH. 2020;Volume 13:621-633. doi:10.2147/JMDH.S254016
Gerson MC. Autonomic innervation of the heart: Role of molecular imaging. J Nucl Cardiol. 2017;24(4):1454-1456. doi:10.1007/s12350-015-0236-y
Kingma JG, Simard D, Rouleau JR. Autonomic Nervous System and Neurocardiac Physiopathology. In: Svorc P, ed. Autonomic Nervous System. InTech; 2018. doi:10.5772/intechopen.77087
Franciosi S, Perry FKG, Roston TM, Armstrong KR, Claydon VE, Sanatani S. The role of the autonomic nervous system in arrhythmias and sudden cardiac death. Autonomic Neuroscience. 2017;205:1-11. doi:10.1016/j.autneu.2017.03.005
Vanderlei LCM, Pastre CM, Hoshi RA, Carvalho TD de, Godoy MF de. Noções básicas de variabilidade da frequência cardíaca e sua aplicabilidade clínica. Rev Bras Cir Cardiovasc. 2009;24(2):205-217. doi:10.1590/S0102-76382009000200018
Rodrigues B, Lira FS, Consolim-Colombo FM, et al. Role of Exercise Training on Autonomic Changes and Inflammatory Profile Induced by Myocardial Infarction. Mediators of Inflammation. 2014;2014:1-11. doi:10.1155/2014/702473
Tsai SW, Lin YW, Wu SK. The effect of cardiac rehabilitation on recovery of heart rate over one minute after exercise in patients with coronary artery bypass graft surgery. Clin Rehabil. 2005;19(8):843-849. doi:10.1191/0269215505cr915oa
Okutucu S, Karakulak UN, Aytemir K, Oto A. Heart rate recovery: a practical clinical indicator of abnormal cardiac autonomic function. Expert Review of Cardiovascular Therapy. 2011;9(11):1417-1430. doi:10.1586/erc.11.149
Kannankeril PJ, Le FK, Kadish AH, Goldberger JJ. Parasympathetic Effects on Heart Rate Recovery after Exercise. J Investig Med. 2004;52(6):394-401. doi:10.1136/jim-52-06-34
Lieve K. Heart Rate Reduction after Exercise Is Associated with Arrhythmic Events in Patients with Catecholaminergic Polymorphic Ventricular Tachycardia. :30.
Pal R, Singh SN, Chatterjee A, Saha M. Age-related changes in cardiovascular system, autonomic functions, and levels of BDNF of healthy active males: role of yogic practice. AGE. 2014;36(4):9683. doi:10.1007/s11357-014-9683-7
Shibao C, Grijalva CG, Raj SR, Biaggioni I, Griffin MR. Orthostatic Hypotension-Related Hospitalizations in the United States. The American Journal of Medicine. 2007;120(11):975-980. doi:10.1016/j.amjmed.2007.05.009
Moodithaya S, Avadhany ST. Gender Differences in Age-Related Changes in Cardiac Autonomic Nervous Function. Journal of Aging Research. 2012;2012:1-7. doi:10.1155/2012/679345
Silva CR da, Nascimento DC, Bicalho LCD, et al. Relationship between adiposity and heart rate recovery following an exercise stress test in obese older women. Rev Bras Cineantropom Desempenho Hum. 2017;19(5):554. doi:10.5007/1980-0037.2017v19n5p554
Yu Y, Liu T, Wu J, et al. Heart rate recovery in hypertensive patients: relationship with blood pressure control. J Hum Hypertens. 2017;31(5):354-360. doi:10.1038/jhh.2016.86
Manzano BM, Vanderlei LCM, Ramos EM, Ramos D. Acute Effects of Smoking on Autonomic Modulation: Analysis by Poincaré Plot. :6.
Karjalainen JJ, Kiviniemi AM, Hautala AJ, et al. Determinants and Prognostic Value of Cardiovascular Autonomic Function in Coronary Artery Disease Patients With and Without Type 2 Diabetes. Dia Care. 2014;37(1):286-294. doi:10.2337/dc13-1072
Qiu SH, Xue C, Sun ZL, Steinacker JM, Zügel M, Schumann U. Attenuated heart rate recovery predicts risk of incident diabetes: insights from a meta-analysis. Diabet Med. 2017;34(12):1676-1683. doi:10.1111/dme.13517
Sydó N, Sydó T, Gonzalez Carta KA, et al. Prognostic Performance of Heart Rate Recovery on an Exercise Test in a Primary Prevention Population. JAHA. 2018;7(7). doi:10.1161/JAHA.117.008143
radi basuni. PEDOMAN UJI LATIH JANTUNG : Prosedur dan Interpretasi.pdf. Published online 2016. https://inaheart.org/wp-content/uploads/2021/07/Pedoman_Uji_Jantung.pdf
Bayles MP, Swank AM, American College of Sports Medicine, eds. ACSM’s Exercise Testing and Prescription. First edition. Wolters Kluwer; 2018.
Pakpahan HAP, Priyana A, Basha A, Radi B. Factors Affect Heart Rate Recovery After Symptom-limited Exercise Stress Testing. Majalah Kardiologi Indonesia. Published online 2007.
Sharma K, Kohli P, Gulati M. An Update on Exercise Stress Testing. Current Problems in Cardiology. 2012;37(5):177-202. doi:10.1016/j.cpcardiol.2011.11.004
Albouaini K, Egred M, Alahmar A, Wright DJ. Cardiopulmonary exercise testing and its application. Postgraduate Medical Journal. 2007;83(985):675-682. doi:10.1136/hrt.2007.121558
Shaw LJ, Peterson ED, Shaw LK, et al. Use of a Prognostic Treadmill Score in Identifying Diagnostic Coronary Disease Subgroups. Circulation. 1998;98(16):1622-1630. doi:10.1161/01.CIR.98.16.1622
Günaydin ZY, Bektaş O, Gürel YE, et al. The value of the Duke treadmill score in predicting the presence and severity of coronary artery disease. :8.
Ralapanawa U, Sivakanesan R. Epidemiology and the Magnitude of Coronary Artery Disease and Acute Coronary Syndrome: A Narrative Review: JEGH. 2021;11(2):169. doi:10.2991/jegh.k.201217.001
Hata J, Kiyohara Y. Epidemiology of Stroke and Coronary Artery Disease in Asia. Circ J. 2013;77(8):1923-1932. doi:10.1253/circj.CJ-13-0786
Volkan Emren S, Gediz RB, Şenöz O, et al. Decreased heart rate recovery may predict a high SYNTAX score in patients with stable coronary artery disease. Bosn J of Basic Med Sci. 2019;19(1):109-115. doi:10.17305/bjbms.2019.3725
Bağlan Uzunget S, Kader Uzel E, Kurmuş Ö, Ekici B. Relation between heart rate recovery index and syntax score. J Integr Cardiol. 2018;4(5). doi:10.15761/JIC.1000257
Ghaffari S, Kazemi B, Aliakbarzadeh P. Abnormal heart rate recovery after exercise predicts coronary artery disease severity. Cardiology Journal. 2010;17:9.
Laurino MJL, da Silva AKF, Santos LA, et al. Vagal reactivation after a cardiac rehabilitation session associated with hydration in coronary artery disease patients: crossover clinical trial. Sci Rep. 2021;11(1):10482. doi:10.1038/s41598-021-89840-x
Chen Y, Yu Y, Zou W, Zhang M, Wang Y, Gu Y. Association between cardiac autonomic nervous dysfunction and the severity of coronary lesions in patients with stable coronary artery disease. J Int Med Res. 2018;46(9):3729-3740. doi:10.1177/0300060518778416
Dzenkeviciute V, Sapoka V, Kasiulevicius V, Rinkuniene E, Steponeniene R, Einikyte R. Value of Duke treadmill score in predicting coronary artery lesion and the need for revascularisation. :6.
Almeida J, Fonseca P, Dias T, et al. Comparison of Coronary Artery Disease Consortium 1 and 2 Scores and Duke Clinical Score to Predict Obstructive Coronary Disease by Invasive Coronary Angiography. Clin Cardiol. 2016;39(4):223-228. doi:10.1002/clc.22515
Premsagar P, Aldous C, Esterhuizen T. The value of exercise stress testing in prediction of angiography amongst South African patients using quantitative scoring systems. SAHJ. 2021;18(2). doi:10.24170/18-2-4882
Choi JY, Rha SW, Choi BG, et al. Percutaneous Coronary Intervention for Chronic Total Occlusion in Single Coronary Arteries. Texas Heart Institute Journal. 2021;48(2):e197023. doi:10.14503/THIJ-19-7023
DOI: https://doi.org/10.21776/ub.hsj.2022.003.04.4
Refbacks
- There are currently no refbacks.
Copyright (c) 2022 Iskandar Iskandar, Setyasih Anjarwani, Cholid Tri Tjahjono, Budi Satrijo, Valerinna Yogibuana Swastika Putri
This work is licensed under a Creative Commons Attribution 4.0 International License.
