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(Circulation. 2004;110:2778-2780.)
© 2004 American Heart Association, Inc.

Editorial

Heart Rate Recovery

Predictor of Risk Today and Target of Therapy Tomorrow?

Anthony P. Morise, MD

From the Section of Cardiology, Department of Medicine, West Virginia University, Morgantown, WVa.

Correspondence to Dr Anthony P. Morise, Section of Cardiology, Department of Medicine, West Virginia University, HSC-South, 2203 Robert C. Byrd Health Science Center, PO Box 9157, Morgantown, WV 26506. E-mail amorise@pol.net

Key Words: Editorials • exercise • heart rate • prognosis • mortality

An extract of the first 250 words of the full text is provided, because this article has no abstract.

How quickly the heart rate recovers after treadmill exercise testing has been the subject of much interest over the last several years. The observations of Imai et al¹ first prompted the clinical evaluation of heart rate recovery. In healthy subjects, athletes, and patients with heart failure, they demonstrated that early (within 1 minute) heart rate recovery was principally the result of vagal reactivation. The phenomenon was abolished by atropine, unaffected by ß-blockers, independent of workload or age, blunted with heart failure, and accelerated in athletes. The hypothesis joining heart rate recovery and mortality arose from work that associated the autonomic nervous system with sudden cardiac death in the postinfarction setting.² This hypothesis has developed to the point at which autonomic tone is considered a cardiovascular risk factor.³ Particular interest has focused on the ability of heart rate recovery to predict all-cause mortality.^4–13

See p 2851

Michael Lauer’s group from The Cleveland Clinic has been the driving force behind this field of investigation. In this issue of Circulation, these investigators present a further, provocative analysis of data from their center that explores the question of whether heart rate recovery can predict who will survive after coronary revascularization. In their study, Chen et al¹⁴ address an issue that is typically dealt with via randomized controlled studies. In lieu of such a trial, they compiled observational data and applied a modified case-control study design. From a group of 8861 patients who underwent treadmill exercise tests with imaging, they found 552 patients who . . . [Full Text of this Article]

Related Article:

Heart Rate Recovery and Impact of Myocardial Revascularization on Long-Term Mortality

Michael S. Chen, Eugene H. Blackstone, Claire E. Pothier, and Michael S. Lauer
Circulation 2004 110: 2851-2857. [Abstract] [Full Text]