International Journal of Cardiology
Volume 134, Issue 1 , Pages 67-74 , 1 May 2009

Long-term prognostic value of heart-rate recovery after treadmill testing in patients with diabetes mellitus

  • Panagiotis Georgoulias

      Affiliations

    • Department of Nuclear Medicine, Medical School, University of Thessaly and University Hospital of Larissa, Larissa, Greece
    • Corresponding Author InformationCorresponding author. 15 Kritis St. 19009 Rafina, Greece. Tel.: +30 22940 26201, +30 2410 682052; fax: +30 22940 78400, +30 2410 670117.
  • ,
  • Nikolaos Demakopoulos

      Affiliations

    • Department of Nuclear Medicine, NIMTS Hospital, Athens, Greece
  • ,
  • Varvara Valotassiou

      Affiliations

    • Department of Nuclear Medicine, Medical School, University of Thessaly and University Hospital of Larissa, Larissa, Greece
  • ,
  • Alexandros Orfanakis

      Affiliations

    • Department of Cardiology, University Hospital of Heraklion, Heraklion, Greece
  • ,
  • Alexia Zaganides

      Affiliations

    • Department of Nuclear Medicine, Medical School, University of Thessaly and University Hospital of Larissa, Larissa, Greece
  • ,
  • Ioannis Tsougos

      Affiliations

    • Department of Medical Physics, Medical School, University of Thessaly, Larissa, Greece
  • ,
  • Ioannis Fezoulidis

      Affiliations

    • Department of Nuclear Medicine, Medical School, University of Thessaly and University Hospital of Larissa, Larissa, Greece

Received 24 June 2007 ,Revised 17 October 2007 ,Accepted 14 January 2008.

References 

  1. Ellestad MH. Chronotropic incompetence. The implications of heart rate response to exercise (compensatory parasympathetic hyperactivity?). Circulation. 1996;93:1485–1487
  2. Arai Y, Saul JP, Albrecht P, et al. Modulation of cardiac autonomic activity during and immediately after exercise. Am J Physiol. 1989;256:H 132–H 141
  3. Imai K, Sato H, Hori M, et al. Vagally mediated heart rate recovery after exercise is accelerated in athletes but blunted in patients with chronic heart failure. J Am Coll Cardiol. 1994;24:1529–1535
  4. May O, Arildsen H, Damsgaard EM, Mickley H. Cardiovascular autonomic neuropathy in insulin-dependent diabetes mellitus: prevalence and estimated risk of coronary heart disease in the general population. J Intern Med. 2000;248:483–491
  5. Seshadri N, Acharya N, Lauer MS. Association of diabetes mellitus with abnormal heart rate recovery in patients without known coronary artery disease. Am J Cardiol. 2003;91:108–111
  6. Cole CR, Blackstone EH, Pashkow FJ, Snader CE, Lauer MS. Heart-rate recovery immediately after exercise as a predictor of mortality. N Engl J Med. 1999;341:1351–1357
  7. Desai MY, De La Pena-Almaguer E, Mannting F. Abnormal heart rate recovery after exercise: a comparison with known indicators of increased mortality. Cardiology. 2001;96:38–44
  8. Cole CR, Foody JM, Blackstone EH, Lauer MS. Heart rate recovery after submaximal exercise testing as a predictor of mortality in a cardiovascularly healthy cohort. Ann Intern Med. 2000;132:552–555
  9. Watanabe J, Thamilarasan M, Blackstone EH, Thomas JD, Lauer MS. Heart rate recovery immediately after treadmill exercise and left ventricular systolic dysfunction as predictors of mortality; the case of stress echocardiography. Circulation. 2001;104:1911–1916
  10. Nishime EO, Cole CR, Blackstone EH, Pashkow FJ, Lauer MS. Heart rate recovery and treadmill exercise score as predictors of mortality in patients referred for exercise ECG. JAMA. 2000;284:1392–1398
  11. Cheng YJ, Lauer MS, Earnest CP, et al. Heart rate recovery following maximal exercise testing as a predictor of cardiovascular disease and all cause mortality in men with diabetes. Diabetes Care. 2003;26:2052–2057
  12. Nesto RW. Correlation between cardiovascular disease and diabetes mellitus: current concepts. Am J Med. 2004;116:11S–22S
  13. Coutinho M, Gerstein HC, Wang Y, Yusuf S. The relationship between glucose and incident cardiovascular events. A meta regression analysis of published data from 20 studies of 95,783 individuals followed for 12.4 years. Diabetes Care. 1999;22:233–240
  14. American Diabetes Association . Diagnosis and classification of diabetes mellitus. Diabetes Care. 2004;27:S5–S10
  15. Coster CD, Quan H, Finlayson A, et al. Identifying priorities in methodological research using ICD-9-CM and ICD-10 administrative data: report from an international consortium. BMC Health Services Res. 2006;6:77
  16. Pitsavos CH, Chrysohoou C, Panagiotakos DB, et al. Exercise capacity and heart rate recovery as predictors of coronary heart disease events, in patients with heterozygous familial hypercholesterolemia. Atherosclerosis. 2004;173:347–352
  17. Georgoulias P, Orfanakis A, Demakopoulos N, et al. Abnormal heart rate recovery immediately after treadmill testing: correlation with clinical, exercise testing, and myocardial perfusion parameters. J Nucl Cardiol. 2003;10:498–505
  18. Georgoulias P, Demakopoulos N, Orfanakis A, et al. Evaluation of abnormal heart-rate recovery after exercise testing in patients with diabetes mellitus: correlation with myocardial SPECT and chronotropic parameters. Nucl Med Commun. 2007;28:165–171
  19. Fletcher GF, Balady G, Froelicher VF, Hartley LH, Haskell WL, Pollock ML. Exercise standards. A statement for healthcare professionals from the American Heart Association Writing Group. Circulation. 1995;91:580–615
  20. Lauer MS, Francis GS, Okin PM, Pashkow FJ, Snader CE, Marwick TH. Impaired chronotropic response to exercise stress testing as a predictor of mortality. JAMA. 1999;281:524–529
  21. Rahimi K, Thomas A, Adam M, Hayerizadeh BF, Schuler G, Secknus MA. Implications of exercise test modality on modern prognostic markers in patients with known or suspected coronary artery disease: treadmill versus bicycle. Eur J Cardiovasc Prev Rehabil. 2006;13:45–50
  22. Mark DB, Shaw L, Harrell FE, et al. Prognostic value of a treadmill exercise score in outpatients with suspected coronary artery disease. N Engl J Med. 1991;325:849–853
  23. Georgoulias P, Demakopoulos N, Kontos A, et al. 99mTc-tetrofosmin myocardial perfusion imaging: a comparison with coronary angiography. Nuklearmedizin. 1996;35:153–155
  24. Hesse B, Tägil K, Cuocolo A, et al. EANM/ESC procedural guidelines for myocardial perfusion imaging in nuclear cardiology. Eur J Nucl Med. 2005;32:855–897
  25. Kapur A, Latus KA, Davies G, et al. A comparison of three radionuclide myocardial perfusion tracers in clinical practice: the ROBUST study. Eur J Nucl Med. 2002;29:1608–1616
  26. Cerquira MD, Weissman NJ, Dilsizian V, et al. Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart: a statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. J Nucl Med. 2002;9:240–245
  27. Schinkel AFL, Elhendy A, Van Domburg RT, Bax JJ, Vourvouni EC, Bountioukos M. Incremental value of exercise technetium-99m tetrofosmin myocardial perfusion single-photon emission computed tomography for the prediction of cardiac events. Am J Cardiol. 2003;91:408–411
  28. Panzer C, Lauer MS, Brieke A, Blackstone E, Hoogwerf B. Association of fasting plasma glucose with heart rate recovery in healthy adults. A population-based study. Diabetes. 2002;51:803–807
  29. Mora S, Redberg RF, Cui Y, et al. Ability of exercise testing to predict cardiovascular and all-cause death in asymptomatic women: a 20-year follow-up of the lipid research clinics prevalence study. JAMA. 2003;290:1600–1607
  30. Morise AP. Heart rate recovery: predictor of risk today and target of therapy tomorrow?. Circulation. 2004;110:2778–2780
  31. Malik M, Camm AJ . Components of heart rate variability — what they really mean and what we really measure. Am J Cardiol. 1993;72:821–822
  32. Tsuji H, Venditti FJ, Manders ES, et al. Determinants of heart rate variability. J Am Coll Cardiol. 1996;28:1539–1546
  33. Singh JP, Larson MG, O CJ, Donnell , et al. Association of hyperglycemia with reduced heart rate variability (The Framingham Heart Study). Am J Cardiol. 2000;86:309–312
  34. Aso Y, Fujiwara Y, Inukai T, Takemura Y. Power spectral analysis of heart rate variation in diabetic patients with neuropathic foot ulceration. Diabetes Care. 1998;21:1173–1177
  35. Emdin M, Gastaldelli A, Muscelli E, et al. Hyperinsulinemia and autonomic nervous system dysfunction in obesity: effects of weight loss. Circulation. 2001;103:513–519
  36. Van De Borne P, Hausberg M, Hoffman RP, Mark AL, Anderson EA. Hyperinsulinemia produces cardiac vagal withdrawal and nonuniform sympathetic activation in normal subjects. Am J Physiol. 1999;276:R 178–R 183
  37. Carnethon MR, Jacobs DR, Sidney S, Liu K. Influence of autonomic nervous system dysfunction on the development of type 2 diabetes. The Cardia study. Diabetes Care. 2003;26:3035–3041
  38. Lima RS, Lorenzo AD, Soares AJ. Relation between postexercise abnormal heart rate recovery and myocardial damage evidenced by gated single-photon emission computed tomography. AJC. 2006;97:1452–1454
  39. Nonaka A, Shiotani H, Kitano K, Yokoyama M. Determinants of heart rate recovery in patients with suspected coronary artery disease. Kobe J Med Sci. 2007;53:93–98
  40. Bilsel T, Terzi S, Akbulut T, Sayar N, Hobikoglu G, Yesilcimen K. Abnormal heart rate recovery immediately after cardiopulmonary exercise testing in heart failure patients. Int Heart J. 2006;47:431–440
  41. Lautamäki R, Dnyanesh T, Bengel FM. Cardiac sympathetic neuronal imaging using PET. Eur J Nucl Med Mol Imaging. 2007;34:S74–S85

PII: S0167-5273(08)00340-9

doi: 10.1016/j.ijcard.2008.01.036

International Journal of Cardiology
Volume 134, Issue 1 , Pages 67-74 , 1 May 2009