Correlation between Heart rate recovery and Left Atrial phasic functions evaluated by 2D speckle-tracking Echocardiography after Acute Myocardial infarction

Abstract

Background Heart rate recovery (HRR) in the exercise test is the index of cardiac autonomic system function and sympathovagal balance impaired in patients with myocardial infarction (MI). An instance is left atrial (LA) phasic function, which is impaired in such patients. In this study, we investigated the role of HRR in predicting LA phasic functions in patients with MI. Methods The present study recruited 144 consecutive patients with ST-elevation MI. A symptom-limited exercise test was performed about 5 weeks after MI, with echocardiography conducted just before the exercise test. The patients were divided into abnormal and normal HRR at 60 s (HRR60) and again into abnormal and normal HRR at 120 s (HRR120) after the exercise test. LA phasic functions, evaluated by 2D speckle-tracking echocardiography, were compared between the 2 groups. Results Patients with abnormal HRR120 had lower LA strain values and strain rates during the reservoir, conduit, and contraction phases, while those with abnormal HRR60 had lower LA strain values and strain rates during the reservoir and conduit phases. The differences were lost after adjustments for possible confounders, except for LA strain and strain rate during the conduit phase, in patients with abnormal HRR120. Conclusions Abnormal HRR120 in the exercise test can independently predict decreased LA conduit function in patients with ST-elevation MI.

Heart Rate Recovery: Up to Date in Heart Failure—A Literature Review

“…Interestingly, blunted HRR has been shown to relate positively to the left atrial volume index, indicating that cardiac dysautonomia mechanisms may contribute to cardiac remodeling processes [ 51 ]. As shown in a recent study, abnormal strain rates during the reservoir, conduit, and contraction phases of the left atrium were associated with blunted HRR 120 s in patients with ST-segment elevation myocardial infarction [ 52 ].…”