מתוך medicontext.co.il
NEW YORK (Reuters Health) – A patient's heart rate at 1 or 2 minutes after a treadmill test has prognostic value and can supplement other test responses, according to a report in the December issue of the Journal of the American College of Cardiology.
Dr. Victor F. Froelicher and colleagues from the Veterans Affairs Palo Alto Health Care System, California, examined mortality data on 2193 male patients who were referred for evaluation of chest pain and underwent treadmill testing and coronary angiography between 1987 and 1999. The endpoint, after a mean follow-up of 7 years, was all-cause mortality, and the diagnostic gold standard was coronary angiography.
Heart rate recovery at 2 minutes after exercise was superior to all other time points in predicting mortality. A decrease of less than 22 beats per minute conferred a hazard ratio of 2.6, the team reports. Beta-blockers did not appear to affect the prognostic power of heart rate recovery.
"This new measurement was ranked similarly to traditional variables including age and metabolic equivalents for predicting death but failed to have diagnostic power for discriminating those who had angiographic disease," the investigators note.
"The drop of heart rate in recovery or its score should supplement, but not replace, the Duke treadmill score that has been validated as a predictor of infarct-free survival and diagnostic of angiographic coronary artery disease," Dr. Froelicher and colleagues conclude.
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