Heart rate recovery: a practical clinical indicator of abnormal cardiac autonomic function

Abstract

The autonomic nervous system (ANS) and cardiovascular function are intricately and closely related. One of the most frequently used diagnostic and prognostic tools for evaluating cardiovascular function is the exercise stress test. Exercise is associated with increased sympathetic and decreased parasympathetic activity and the period of recovery after maximum exercise is characterized by a combination of sympathetic withdrawal and parasympathetic reactivation, which are the two main arms of the ANS. Heart rate recovery after graded exercise is one of the commonly used techniques that reflects autonomic activity and predicts cardiovascular events and mortality, not only in cardiovascular system disorders, but also in various systemic disorders. In this article, the definition, applications and protocols of heart rate recovery and its value in various diseases, in addition to exercise physiology, the ANS and their relationship, will be discussed.

Discrepancies between Conventional Multiscale Entropy and Modified Short-Time Multiscale Entropy of Photoplethysmographic Pulse Signals in Middle- and Old- Aged Individuals with or without Diabetes

“…To our knowledge, there is a higher probability of microvascular and autonomic nervous dysfunctions of the non-dominant physically inactive hand in diabetes. As has been shown in post-exercise heart rate recovery [22,23], those with impaired cardiac autonomic function would have a slowly declining heart beat rate at one or two minutes after cessation of the treadmill test. This may explain why more numbers of PPG pulse signals are required for the MSE analysis in a multi-comorbid condition.…”

Heart rate recovery after physical exertion tests in elderly hypertensive patients undergoing resistance training

“…HRR evaluation, besides permitting infer a cardiovascular autonomic regulation dysfunction, as evidenced by a slow decline in the 1 st and 2 nd minutes after a stress test (27), can be considered a risk factor for cardiovascular disease and furthermore, shows correlation with mortality from all causes (28 -30). There is also direct correlation of HRR with maximum oxygen uptake, so it is believed that patients with an attenuated response have lower exercise capacity (31,32).…”

Assessment of cardiac autonomic functions by heart rate recovery indices in patients with myocardial bridge

“…Heart rate (HR) recovery (HRR) is a readily obtainable, relatively inexpensive and very simple diagnostic and prognostic tool that reflects the cardiac autonomic functions, which clinicians can apply in various clinical settings [7]. HRR indices show the rate of decline in the HR after the cessation of exercise test and it is defined as HR difference between the maximal HR on exercise and the HR during recovery phase.…”

“…HRR after graded exercise reflects autonomic activity and predicts cardiovascular events and mortality not only in cardiovascular system disorders but also in various systemic disorders [8,9]. As part of a regular routine exercise stress test (EST), HRR provides a risk assessment tool of a prognostic value for the clinicians [7,10].…”

“…Although the HRR indices were assessed in many forms of coronary artery diseases (CAD) [10][11][12], cardiac autonomic functions and HRR indices have not been previously assessed in patients with MB [7]. Therefore, we aimed to assess HRR in patients with MB and compare with control subjects.…”