Decreased heart rate recovery may predict a high SYNTAX score in patients with stable coronary artery disease

An impaired heart rate recovery (HRR) has been associated with increased risk of cardiovascular events, cardiovascular, and all‐cause mortality. However, the diagnostic ability of HRR for the presence and severity of coronary artery disease (CAD) has not been clearly elucidated. Our aim was to investigate the relationship between HRR and the SYNTAX (SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery) score in patients with stable CAD (SCAD). A total of 406 patients with an abnormal treadmill exercise test and ≥50% coronary stenosis on coronary angiography were included. The HRR was calculated by subtracting the HR in the first minute of the recovery period from the maximum HR during exercise. The SYNTAX score ≥23 was accepted as high. Correlation of HRR with SYNTAX score and independent predictors of high SYNTAX score were determined. A high SYNTAX score was present in 172 (42%) patients. Mean HRR was lower in patients with a high SYNTAX score (9.8 ± 4.5 vs. 21.3 ± 9, p < 0.001). The SYNTAX score was negatively correlated with HRR (r: -0.580, p < 0.001). In multivariate logistic regression analysis, peripheral arterial disease (OR: 13.3; 95% CI: 3.120–34.520; p < 0.001), decreased HRR (OR: 0.780; 95% CI: 0.674–0.902; p = 0.001), peak systolic blood pressure (OR: 1.054; 95% CI: 1.023–1.087; p = 0.001), and peak HR (OR: 0.950; 95% CI: 0.923–0.977; p < 0.001) were found to be independent predictors of a high SYNTAX score. Our results showed that HRR is significantly correlated with the SYNTAX score, and a decreased HRR is an independent predictor of a high SYNTAX score in patients with SCAD.

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Association between cardiac autonomic nervous dysfunction and the severity of coronary lesions in patients with stable coronary artery disease

Journal of International Medical Research ◽

10.1177/0300060518778416 ◽

2018 ◽

Vol 46 (9) ◽

pp. 3729-3740 ◽

Cited By ~ 3

Author(s):

Yafei Chen ◽

Yijun Yu ◽

Wusong Zou ◽

Mingjing Zhang ◽

Yuting Wang ◽

...

Keyword(s):

Coronary Artery Disease ◽

Heart Rate ◽

Coronary Artery ◽

Heart Rate Recovery ◽

Stable Coronary Artery Disease ◽

Multivariate Logistic Regression Analysis ◽

Control Group ◽

Autonomic Nervous ◽

Coronary Lesions ◽

Artery Disease

Objective Autonomic dysfunction is recognized in patients with coronary artery disease (CAD) and is related to worse cardiovascular outcome. This study aimed to evaluate cardiac autonomic nervous function by heart rate recovery (HRR) and heart rate variability (HRV), and demonstrate their relationship with the severity of coronary lesions in patients with stable CAD (SCAD). Methods Consecutive patients without CAD (controls, n = 65) and those with SCAD (n = 63) were included in this study. Patients with SCAD were further divided into single- or two-/three-vessel disease, as well as <70% or ≥70% stenosis subgroups. The association between HRR/HRV and coronary lesions was analysed. Results HRR and HRV values were significantly lower in the SCAD group compared with the control group. Multivariate logistic regression analysis showed that abnormal HRR and HRV were risk factors of SCAD. Moreover, delayed HRR was a risk factor of the severity of coronary lesions. Conclusions Our results show that autonomic function is impaired in patients with SCAD and delayed HRR is closely related to the severity of coronary lesions.

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Simple heart rate and QT parameters during stress exercise testing to assess presence and severity of stable coronary artery disease

Future Cardiology ◽

10.2217/fca-2020-0163 ◽

2021 ◽

Author(s):

Murugaiyan Rajarajan ◽

Mugula Sudhakar Rao ◽

Padmakumar Ramachandran ◽

Ashwal A Jayaram

Keyword(s):

Coronary Artery Disease ◽

Heart Rate ◽

Coronary Artery ◽

Heart Rate Recovery ◽

Stable Coronary Artery Disease ◽

Peak Exercise ◽

P Value ◽

Characteristic Analysis ◽

Qt Variability ◽

Artery Disease

Aim: The relationship between QT prolongation and myocardial ischemia is well known, however not many studies have correlated corrected QT interval and heart rate recovery with the severity of coronary artery disease (CAD). Methods: This was a single-center, prospective, observational study which included 127 patients with CAD and 124 patients without CAD. Results: Corrected QT variability from peak to recovery correlated well with CAD with a p value of 0.03. Receiver operative characteristic analysis did not show any significant diagnostic accuracy with any heart rate or QT parameters for predicting the presence or severity of CAD. Conclusion: Coronary artery disease is predicted by reduced ability of the heart rate to rise from rest to peak exercise and reduced recovery of heart rate and corrected QT from peak exercise to recovery at 1 min.

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The Relationship Between Resting Heart Rate and SYNTAX Score in Patients With Stable Coronary Artery Disease

Angiology ◽

10.1177/0003319716649881 ◽

2016 ◽

Vol 68 (2) ◽

pp. 168-173 ◽

Cited By ~ 13

Author(s):

Samet Yilmaz ◽

Fatih Sen ◽

Mehmet K. Akboga ◽

Kevser G. Balci ◽

Dursun Aras ◽

...

Keyword(s):

Coronary Artery Disease ◽

Heart Rate ◽

Coronary Artery ◽

Stable Coronary Artery Disease ◽

Multiple Logistic Regression Analysis ◽

Coronary Intervention ◽

Syntax Score ◽

Resting Heart Rate ◽

Artery Disease ◽

The Relationship

We investigated the relationship between resting heart rate (HR) and The Synergy between percutaneous coronary intervention with Taxus and cardiac surgery (SYNTAX) score in patients with stable coronary artery disease (SCAD). A total of 420 patients who were admitted to our outpatient clinic for stable angina pectoris with sinus rhythm and had at least 50% narrowing in at least 1 coronary artery after coronary angiography were included in the study. Patients were divided into 3 tertiles based on the resting HR: HR of tertile 1 was ≤65 (n = 138), tertile 2 was between 66 and 76 (n = 139), and tertile 3 was ≥77 beats/min (n = 143). The SYNTAX score (7.6 ± 4.6, 12.4 ± 5.6, 20.3 ± 8.1; P < .001) was significantly higher for those in tertile 3 than for those in tertiles 1 and 2. Leukocyte count (7.8 ± 2.2, 7.9 ± 2.2, 8.4 ± 2.3 × 109/L; P = .035) and C-reactive protein (CRP) levels (2.4 ± 0.5, 3.2 ± 0.7, 4.5 ± 1.2 mg/L, P < .001) were increasing from the lowest to the highest tertile. Using multiple logistic regression analysis, CRP (odds ratio [OR] 1.54 [1.17-2.11], P = .001) and resting HR (OR 1.67 [1.25-2.19], P < .001) emerged as independent predictors of SYNTAX score. Resting HR is related to SYNTAX score in patients with SCAD.

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Prognostic value of serum soluble ST2 in stable coronary artery disease: a prospective observational study

Scientific Reports ◽

10.1038/s41598-021-94714-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Hack-Lyoung Kim ◽

Jung Pyo Lee ◽

Nathan Wong ◽

Woo-Hyun Lim ◽

Jae-Bin Seo ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Stable Coronary Artery Disease ◽

Stable Condition ◽

Baseline Serum ◽

Soluble St2 ◽

Increased Risk ◽

Artery Disease ◽

Stable Cad

AbstractThe role of ST2 in stable coronary artery disease (CAD) has not yet been well defined. This study was performed to investigate baseline serum soluble ST2 (sST2) level can predict clinical outcomes in patients with stable CAD. A total of 388 consecutive patients with suspected CAD (65 years and 63.7% male) in stable condition referred for elective invasive coronary angiography (ICA) was prospectively recruited. Major adverse cardiovascular event (MACE), including cardiac death, non-fatal myocardial infarction, coronary revascularization (90 days after ICA), and ischemic stroke during clinical follow-up was assessed. Most of the patients (88.0%) had significant CAD (stenosis ≥ 50%). During median follow-up of 834 days, there was 29 case of MACE (7.5%). The serum sST2 level was significantly higher in patients with MACE than those without (47.3 versus 30.6 ng/ml, P < 0.001). In multiple Cox regression model, higher sST2 level (≥ 26.8 ng/ml) was an independent predictor of MACE even after controlling potential confounders (hazard ratio, 13.7; 95% confidence interval 1.80–104.60; P = 0.011). The elevated level of baseline sST2 is associated with an increased risk of adverse clinical events in stable CAD patients. Studies with larger sample size are needed to confirm our findings.

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