Impaired heart rate recovery as a predictor for poor health-related quality in patients with transient ischemic attack

Li, Xuanmin; Wang, Ya-Fang; Mi, Xue; Qiao, Zhaona; Liang, Yongmei

doi:10.1097/md.0000000000016938

Cited by 3 publications

(4 citation statements)

References 27 publications

(26 reference statements)

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“…Few studies have examined heart rate recovery in individuals with stroke, none of which have examined recovery to this length of time post-exercise. In individuals with TIA, Li et al (2019) found that heart rate recovery was impaired at 5-min post-exercise (54 ± 16 bpm) compared to control subjects without a history of TIA (73 ± 15 bpm), at levels indicative of autonomic dysfunction. Our sample produced heart rate recovery values at 5 min postexercise (58 ± 23 bpm) that were very similar their findings (Li et al, 2019).…”

Section: Discussionmentioning

confidence: 93%

“…In individuals with TIA, Li et al (2019) found that heart rate recovery was impaired at 5-min post-exercise (54 ± 16 bpm) compared to control subjects without a history of TIA (73 ± 15 bpm), at levels indicative of autonomic dysfunction. Our sample produced heart rate recovery values at 5 min postexercise (58 ± 23 bpm) that were very similar their findings (Li et al, 2019). The sustained elevations of cfPWV and impaired heart rate recovery may be yet another indicator of autonomic imbalances in this population, especially after exercise.…”

Section: Discussionmentioning

confidence: 93%

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Prolonged Elevation of Arterial Stiffness Following Peak Aerobic Exercise in Individuals With Chronic Stroke

et al. 2021

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BackgroundStroke is a highly disabling condition and is the second leading cause of death globally. Engaging in aerobic exercise is important for the prevention of a recurrent stroke through improving markers of cardiovascular health such as blood pressure and arterial stiffness. While higher intensities of aerobic exercise generally elicit greater cardioprotective effects, little is known about the acute cardiovascular effects of a single session of high intensity aerobic exercise in people with stroke. The objective of this study was to model the recovery of arterial stiffness (carotid-femoral pulse wave velocity, cfPWV), heart rate and blood pressure following peak intensity aerobic exercise in individuals with chronic stroke.MethodsTen participants with chronic stroke (mean ± SD age = 56.9 ± 11.8 years, median [IQR] years post-stroke = 2.9 [1.9]) performed a symptom-limited cardiopulmonary exercise test (CPET) on a recumbent stepper. Before the CPET, resting cfPWV, heart rate and blood pressure were measured. Immediately following the CPET, all outcomes were measured again continuously for 20 min to use all available observations (n = 245 observations) and capture any potential non-linear changes. Mixed model analyses were then applied to model post-exercise changes of cfPWV, heart rate and blood pressure.ResultsCarotid-femoral pulse wave velocity was increased from rest following the CPET (9.0 ± 0.53 to 9.9 ± 0.52 m/s, p < 0.001) and remained elevated for 20 min into post-exercise recovery, independent of heart rate (p = 0.001). Heart rate also increased from baseline (71.2 ± 3.2 to 77.4 ± 3.1 bpm, p < 0.001) and remained elevated for 10 min post-exercise (p < 0.001). Finger systolic blood pressure was reduced from rest (117.3 ± 4.7 to 111.8 ± 4.6 mmHg, p < 0.001) and remained reduced for 15 min after exercise (p < 0.001). There were no significant differences in finger diastolic or mean arterial pressures from rest.ConclusionThis was the first study to capture continuous changes in cfPWV following peak aerobic exercise in any clinical population. The present study revealed that cfPWV is elevated for 20 min after peak aerobic exercise in individuals with stroke, which was independent of heart rate. These findings suggest there may be autonomic imbalances in large arteries following peak intensity aerobic exercise in individuals with stroke.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 93%

Prolonged Elevation of Arterial Stiffness Following Peak Aerobic Exercise in Individuals With Chronic Stroke

et al. 2021

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“…HRR abnormalities are often seen in patients with metabolic disorders, including cardiovascular disease, fatty liver, diabetes and prehypertension [4][5][6][7][8]. Blunted HRR has been reported the association with chronic heart failure and new-onset atrial fibrillation [9,10].…”

Section: Introductionmentioning

confidence: 99%

Delayed blood pressure recovery after exercise stress test is associated with autonomic dysfunction and pulse pressure in a middle-aged healthy group

Lee,

Kim,

et al. 2023

PLoS ONE

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Background Delayed heart rate (HR) and blood pressure recovery after exercise test is known as the reliable indexes of autonomic dysfunction. Here we tried to evaluate the serial changes in various indicators during exercise test and correlations with recovery of HR and blood pressure in a normotensive healthy middle-aged group. Methods A total of 122 patients without hypertension or diabetes was enrolled (mean age, 55.6 ± 11.0; male, 56.6%; mean blood pressure, 124.8 ± 16.6 / 81.5 ± 9.6 mmHg). Treadmill test was performed for evaluation of chest pain. Patients with coronary artery disease, positive treadmill test result, left ventricular dysfunction or renal failure were excluded. Heart rate recovery was calculated by subtracting the HR in the first or second minute of recovery period from the HR of peak exercise (HRR1 or HRR2). Systolic blood pressure in the 4th minute of recovery stage (SBPR4) was used to show delayed blood pressure recovery. Results Metabolic equivalents (METs) and HR in stage 2 to 4 were significantly correlated with both HRR1 and HRR2. Multiple regression analysis of HRR revealed significant correlation of METs and SBPR4. SBPR4 was significantly correlated with both HRR1 and HRR2 (HRR1, r = -0.376, p<0.001; HRR2, r = -0.244, p = 0.008) as well as SBP in the baseline to stage 3 and pulse pressure (r = 0.406, p<0.001). Conclusions Delayed BP recovery after peak exercise test revealed significant association with autonomic dysfunction and increased pulse pressure in normotensive middle-aged healthy group. It can be a simple and useful marker of autonomic dysfunction and arterial stiffness.

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Section: Introductionmentioning

confidence: 99%

Delayed blood pressure recovery after exercise stress test is associated with autonomic dysfunction and pulse pressure in a middle-aged healthy group

Yoon

Lee

Kim

et al. 2023

Preprint

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Background: Delayed heart rate (HR) and blood pressure recovery after exercise test is known as the reliable indexes of autonomic dysfunction. Here we tried to evaluate the serial changes in various indicators during exercise test and correlations among them in a normotensive healthy middle-aged group. Methods: A total of 122 patients without hypertension or diabetes was enrolled (mean age, 55.6 ± 11.0; male, 56.6 %; mean blood pressure, 124.8 ±16.6 / 81.5 ± 9.6 mmHg). Treadmill test was performed for evaluation of chest pain. Patients with coronary artery disease, positive treadmill test result, left ventricular dysfunction or renal failure were excluded. Heart rate recovery was calculated by subtracting the HR in the first or second minute of recovery period from the HR of peak exercise (HRR1 or HRR2). Systolic blood pressure in the 4th minute of recovery stage (SBPR4) was used to show delayed blood pressure recovery. Results: Metabolic equivalents (METs) and HR in stage 2 to 4 were significantly correlated with both HRR1 and HRR2. Multiple regression analysis of HRR revealed significant correlation of METs and SBPR4. SBPR4 was significantly correlated with both HRR1 and HRR2 (HRR1, r=-0.376, p<0.001; HRR2, r=-0.244, p=0.008). SBPR4 revealed significant correlation with SBP in the baseline to stage 3 and pulse pressure (r=0.406, p<0.001). Conclusions: Delayed BP recovery after peak exercise test revealed significant association with autonomic dysfunction and pulse pressure in normotensive middle-aged healthy group. It can be a simple and useful marker of autonomic dysfunction and arterial stiffness.

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Impaired heart rate recovery as a predictor for poor health-related quality in patients with transient ischemic attack

Cited by 3 publications

References 27 publications

Prolonged Elevation of Arterial Stiffness Following Peak Aerobic Exercise in Individuals With Chronic Stroke

Prolonged Elevation of Arterial Stiffness Following Peak Aerobic Exercise in Individuals With Chronic Stroke

Delayed blood pressure recovery after exercise stress test is associated with autonomic dysfunction and pulse pressure in a middle-aged healthy group

Delayed blood pressure recovery after exercise stress test is associated with autonomic dysfunction and pulse pressure in a middle-aged healthy group

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