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

  • Sadık Volkan Emren Department of Cardiology, Katip Celebi University School of Medicine, Izmir, Turkey
  • Rahman Bilal Gediz Department of Cardiology, Manisa State Hospital, Manisa, Turkey
  • Oktay Şenöz Department of Cardiology, Çiğli State Hospital, Izmir, Turkey
  • Uğur Karagöz Department of Cardiology, Katip Celebi University School of Medicine, Izmir, Turkey
  • Ersin Çağrı Şimşek Department of Cardiology, Tepecik Training and Education Hospital, Izmir, Turkey
  • Fatih Levent Department of Cardiology, Tınaztepe Hospital, Izmir, Turkey
  • Emre Özdemir Department of Cardiology, Katip Celebi University School of Medicine, Izmir, Turkey
  • Mustafa Ozan Gürsoy Department of Cardiology, Katip Celebi University School of Medicine, Izmir, Turkey
  • Cem Nazlı Department of Cardiology, Katip Celebi University School of Medicine, Izmir, Turkey
Keywords: Heart rate recovery, SYNTAX score, coronary artery disease, CAD, HRR

Abstract

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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Author Biographies

Sadık Volkan Emren, Department of Cardiology, Katip Celebi University School of Medicine, Izmir, Turkey
Department of Cardiology
Rahman Bilal Gediz, Department of Cardiology, Manisa State Hospital, Manisa, Turkey
Department of Cardiology
Oktay Şenöz, Department of Cardiology, Çiğli State Hospital, Izmir, Turkey
Department of Cardiology
Uğur Karagöz, Department of Cardiology, Katip Celebi University School of Medicine, Izmir, Turkey
Department of Cardiology
Ersin Çağrı Şimşek, Department of Cardiology, Tepecik Training and Education Hospital, Izmir, Turkey
Department of Cardiology
Fatih Levent, Department of Cardiology, Tınaztepe Hospital, Izmir, Turkey
Department of Cardiology
Emre Özdemir, Department of Cardiology, Katip Celebi University School of Medicine, Izmir, Turkey
Department of Cardiology
Mustafa Ozan Gürsoy, Department of Cardiology, Katip Celebi University School of Medicine, Izmir, Turkey
Department of Cardiology
Cem Nazlı, Department of Cardiology, Katip Celebi University School of Medicine, Izmir, Turkey
Department of Cardiology
Decreased heart rate recovery may predict a high SYNTAX score in patients with stable coronary artery disease
Published
2019-02-12
How to Cite
1.
Volkan Emren S, Gediz RB, Şenöz O, Karagöz U, Şimşek E Çağrı, Levent F, Özdemir E, Gürsoy MO, Nazlı C. Decreased heart rate recovery may predict a high SYNTAX score in patients with stable coronary artery disease. Bosn J of Basic Med Sci [Internet]. 2019Feb.12 [cited 2019Jul.23];19(1):109-15. Available from: https://www.bjbms.org/ojs/index.php/bjbms/article/view/3725
Section
Translational and Clinical Research