Heart Rate Recovery in Patients with Ischemic Heart Disease - Risk Factors

BACKGROUND AND AIM. Central nervous system dysfunction is associated with mortality and morbidity in patients with cardiovascular disease, post-workout recovery and faster heart rate being mediated by the dynamic interaction between the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS), as components of the autonomic nervous system. Heart rate recovery is the decline in heart rate after exercise. The aim of the study was to determine the influence of certain clinical and paraclinical parameters on heart rate recovery after exercise in patients with ischemic heart disease. METHODS. The study included 260 patients who were subjected to cardiovascular stress test. The following parameters were measured in each patient: blood pressure and pulse rate prior to exercise, during exercise and at protocol-established time intervals, as well as 1 and 3 minutes after the end of the stress test. Statistical analysis was performed using MedCalc software version 14.8.1 RESULTS. Elderly patients had slower heart rate recovery at 1 minute after effort. Female patients have recovered significantly better the heart rate, at 1 minute and 3 minutes after effort compared to the males. This difference was maintained in multivariate analysis, independent of age or comorbidities of patients. The presence of ischemic heart disease was the most important factor independently associated with HRR1. Triglyceride values were negatively correlated with both HRR3 and HRR1 and independent of other factors present in the multivariate analysis. CONCLUSIONS. Autonomic dysfunction is involved in the development of cardiovascular risk factors like hypertension, diabetes, dyslipidemia and was directly correlated with morbidity and mortality caused by coronary heart disease.