TY - JOUR
T1 - Heart Rate Recovery 10 Seconds After Cessation of Exercise Predicts Death
AU - van de Vegte, Yordi J
AU - van der Harst, Pim
AU - Verweij, Niek
N1 - Funding Information:
This research was conducted using the UK Biobank. We would like to thank the Center for Information Technology of the University of Groningen for their support and for providing access to the Peregrine high-performance computing cluster. We thank Ruben N. Eppinga, MD; Tom Hendriks, MD; M. Yldau van der Ende, BSc; M. Abdullah Said, BSc; the University of Groningen; the University Medical Center Groningen, Department of Cardiology; and Yanick Hagemeijer, MSc, for their contributions to the extraction and processing of data in the UK Biobank. None of the mentioned contributors received compensation, except for their employment at the University Medical Center Groningen. We also thank Dr Thomas Teijeiro for his assistance with the Construe algorithm. Verweij is funded by a Marie Sklodowska-Curie Global Fellowship (call: H2020-MSCA-IF-2014, project ID: 661395) and a 'Nederlandse Organisatie voor Wetenschappelijk Onderzoek' VENI grant (016.186.125) in support of research into ECG changes in response to exercise.
Publisher Copyright:
© 2018 The Authors.
PY - 2018/4/17
Y1 - 2018/4/17
N2 - 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.
AB - 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.
KW - Adult
KW - Aged
KW - Cause of Death/trends
KW - Coronary Artery Disease/diagnosis
KW - Electrocardiography
KW - Exercise Test
KW - Exercise Tolerance/physiology
KW - Female
KW - Follow-Up Studies
KW - Heart Rate/physiology
KW - Humans
KW - Male
KW - Middle Aged
KW - Predictive Value of Tests
KW - Prognosis
KW - Recovery of Function
KW - Retrospective Studies
KW - Risk Factors
KW - Survival Rate/trends
KW - United Kingdom/epidemiology
KW - Mortality
KW - Autonomic nervous system
KW - Exercise testing
KW - Heart rate recovery
UR - http://www.scopus.com/inward/record.url?scp=85045334568&partnerID=8YFLogxK
U2 - 10.1161/JAHA.117.008341
DO - 10.1161/JAHA.117.008341
M3 - Article
C2 - 29622586
SN - 2047-9980
VL - 7
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 8
M1 - e008341
ER -