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Novel predictor of prognosis from exercise stress testing: heart rate variability response to the exercise treadmill test.

Abstract：

BACKGROUND:Although the prognostic power of heart rate variability (HRV) at rest has been demonstrated, the prognostic potential of exercise-induced HRV has not been investigated. We aimed to evaluate the prognostic power of exercise-induced HRV during and after standard exercise testing. METHODS:Time- and frequency-domain HRV analysis was performed on R-R interval data taken from 1335 subjects (95% male, mean age 58 years) during the first and last 2 minutes of exercise treadmill testing and the first 2 minutes of recovery. Cox survival analysis was performed for the 53 cardiovascular and 133 all-cause mortality end points that accrued during the 5.0-year mean follow-up. RESULTS:After adjusting for potential confounders, greater root mean square successive difference in R-R interval during peak exercise and recovery, greater high-frequency (HF) power and percentage of HF power, lower percentage of low-frequency power, and lower ratio of low frequency to HF during recovery were significantly associated with increased risks for all-cause and cardiovascular death. Of all time-domain variables considered, the log of the root mean square successive difference during recovery was the strongest predictor of cardiovascular mortality (adjusted hazard ratio 5.0, 95% CI 1.5-17.0 for the top quintile compared with the lowest quintile). Log HF power during recovery was the strongest predictor of cardiovascular mortality in the frequency domain (adjusted hazard ratio 5.9, 95% CI 1.3-25.8 for the top quintile compared with the lowest quintile). CONCLUSIONS:Exercise-induced HRV variables during and after clinical exercise testing strongly predict both cardiovascular and all-cause mortality independent of clinical factors and exercise responses in our study population.

journal_name

Am Heart J

journal_title

American heart journal

authors

Dewey FE,Freeman JV,Engel G,Oviedo R,Abrol N,Ahmed N,Myers J,Froelicher VF

doi

10.1016/j.ahj.2006.11.001

subject

Has Abstract

pub_date

2007-02-01 00:00:00

pages

281-8

issue

eissn

0002-8703

issn

1097-6744

pii

S0002-8703(06)00975-6

journal_volume

153

pub_type

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Novel predictor of prognosis from exercise stress testing: heart rate variability response to the exercise treadmill test.