Decreased heart rate recovery may predict a high SYNTAX score in patients with stable coronary artery disease

Abstract

An impaired heart rate recovery (HRR) has been associated with increased risk of cardiovascular events, cardiovascular, and all‐cause mortality. However, the diagnostic ability of HRR for the presence and severity of coronary artery disease (CAD) has not been clearly elucidated. Our aim was to investigate the relationship between HRR and the SYNTAX (SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery) score in patients with stable CAD (SCAD). A total of 406 patients with an abnormal treadmill exercise test and ≥50% coronary stenosis on coronary angiography were included. The HRR was calculated by subtracting the HR in the first minute of the recovery period from the maximum HR during exercise. The SYNTAX score ≥23 was accepted as high. Correlation of HRR with SYNTAX score and independent predictors of high SYNTAX score were determined. A high SYNTAX score was present in 172 (42%) patients. Mean HRR was lower in patients with a high SYNTAX score (9.8 ± 4.5 vs. 21.3 ± 9, p < 0.001). The SYNTAX score was negatively correlated with HRR (r: -0.580, p < 0.001). In multivariate logistic regression analysis, peripheral arterial disease (OR: 13.3; 95% CI: 3.120–34.520; p < 0.001), decreased HRR (OR: 0.780; 95% CI: 0.674–0.902; p = 0.001), peak systolic blood pressure (OR: 1.054; 95% CI: 1.023–1.087; p = 0.001), and peak HR (OR: 0.950; 95% CI: 0.923–0.977; p < 0.001) were found to be independent predictors of a high SYNTAX score. Our results showed that HRR is significantly correlated with the SYNTAX score, and a decreased HRR is an independent predictor of a high SYNTAX score in patients with SCAD.

Koroner Arter Hastalığının Öngördürücüleri Olarak Trigliserid Glikoz İndeksi ve Trigliserid / HDL Oranı

“…SYNTAX score and lipid parameters were evaluated in previous studies. In the group including NSTEMI patients, the relationship between SYNTAX score and HDL value was significant (22), while no relationship was found between low and high SYNTAX score and dyslipidemia in stable CAD (23). Another reason is that the nutritional deficiency that develops on the basis of chronic disease in the presence of severe CAD may have caused the difference to decrease in the advanced stage and the results to be insignificant.…”

Association between arterial stiffness and autonomic dysfunction in participants underwent treadmill exercise testing: a cross-sectional analysis

“…HRR is a reliable and reproducible parameter that reflects immediate alterations in autonomic nerve function after the termination of exercise 27 . Of note, it has been shown that slow HRR is associated with the severity of coronary artery disease in participants without traditional CV risk factors 28 , 29 . Furthermore, it predicts future CV morbidity and mortality 14 , 15 .…”