부산대학교 도서관

Background: Heart rate recovery (HRR) after exercise is an independent prognostic tool for cardiovascular (CV) morbidity and mortality. The aim of this study is to detect the determinants of HRR in ischemic heart di sease patients undergoing PCI with and without Type II Diabetes (T2D) and to assess its short term prognostic value. Methods: We examined the correlation between HRR and Clinical, Laboratory, Echocardiography, stress test and coronary angiography data in our cohort (100 patients with positive exercise test and PCI within 90 days, age 49 ±10 years, 71 males, 50% with T2D). We followed them up for 6 months and tested how impaired HRR (IHRR) predicts CV morbidity and mortality and compared data between diabetics and non diabetics. Results: HRR closely correlated with age, presence of T2D, resting HR, METs, Diastolic dysfunction, LA size and number of coronary lesions. A stepwise linear regression model revealed age, T2D, Resting HR and Diastolic dysfunction as predictors of IHRR. In diabetics HRR was strongly correlated with resting HR, METs, LA size and TG level. A stepwise linear regression model showed resting HR, LA size and TG level as predictors of IHRR. In non diabetics only resting HR was strongly correlated with HRR. Kaplan-Meier survival analysis showed IHRR predicted mortality. Cox regression models found that IHRR predicted arrhythmia and CV composite end point. In diabetics IHRR predicted CV composite end point but not in non-diabetics. Conclusion: Age, T2D, Resting HR, and Diastolic dysfunction were determinants of HRR among PCI patients. In diabetics resting HR, LA size and TG level its determinants. In non diabetics resting HR was the only determinant. In patients with T2D IHRR predicted CV composite end point but did not predict mortality. In non diabetics IHRR did not predict any of the endpoints. [ABSTRACT FROM AUTHOR]