Background

Little is known if heart rate responses during and after exercise test may be associated with the risk of sudden cardiac death (SCD). Our aim was to determine if exercise heart rate reserve and recovery, providing non-invasive indices, may predict SCD risk in general male population.

Methods

We evaluated the impact of delayed heart rate reserve and slow heart rate recovery and the risk of SCD in the Kuopio Ischemic Heart Disease prospective cohort study of randomly selected 1967 men aged 42–61 years at recruitment. Heart rate reserve was calculated as the difference between the maximal attained heart rate and resting heart rate, whereas heart rate recovery was defined as maximal heart rate minus the heart rate measured at 2 min of recovery, on a symptom-limited cardiopulmonary exercise testing.

Results

During a median follow-up interval of 25 years, 209 events of SCD occurred. The age and examination adjusted relative hazards of SCD were in the lowest third of heart rate reserve 3.86 (95% confidence interval (CI) 2.56–5.80, p < 0.001) and the lowest third of heart rate recovery 2.86 (95% CI 1.95–4.20, p < 0.001) as compared to men in the highest third of heart rate reserve and heart rate recovery, respectively. After adjusting for potential confounders, the respective relative hazards were 1.96 (95% CI 1.24–3.12) and 1.75 (95% CI 1.16–2.64). Each unit increment (1 beat/min) in heart rate reserve and heart rate recovery decreased the incidence of SCD by 1–2%.

Conclusions

Delayed exercise heart rate reserve and slow heart rate recovery predicted the risk of SCD, suggesting that heart rate responses may be associated with an increased risk for SCD in general population.

中文翻译：

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运动心率储备和恢复是心源性猝死的危险因素

背景

很少有人知道运动测试期间和之后的心率反应是否可能与心源性猝死 (SCD) 的风险相关。我们的目的是确定运动心率储备和恢复，提供非侵入性指标，是否可以预测一般男性人群的 SCD 风险。

方法

我们在 Kuopio 缺血性心脏病前瞻性队列研究中评估了延迟心率储备和缓慢心率恢复的影响，以及随机选择的 1967 名招募时年龄 42-61 岁的男性的 SCD 风险。心率储备计算为最大达到心率和静息心率之间的差异，而心率恢复定义为最大心率减去在症状限制的心肺运动测试中在恢复 2 分钟时测量的心率。

结果

在中位随访 25 年期间，发生了 209 起 SCD 事件。年龄和检查调整后 SCD 的相对危险位于心率储备 3.86 的最低三分之一（95% 置信区间 (CI) 2.56-5.80，p  < 0.001）和心率恢复的最低三分之一（95% CI 1.95- 4.20, p < 0.001) 与分别处于心率储备和心率恢复最高三分之一的男性相比。调整潜在混杂因素后，各自的相对风险为 1.96 (95% CI 1.24–3.12) 和 1.75 (95% CI 1.16–2.64)。心率储备和心率恢复每增加一个单位（1 次/分钟），SCD 的发生率就会降低 1-2%。

结论

延迟的运动心率储备和缓慢的心率恢复预测了 SCD 的风险，表明心率反应可能与普通人群中 SCD 风险的增加有关。