Correlation between heart rate recovery at 1 minute after exercise and long-term prognosis in patients with acute myocardial infarction treated by percutaneous coronary intervention
10.3760/cma.j.cn115455-20200619-00775
- VernacularTitle:经皮冠状动脉介入治疗急性心肌梗死患者运动后1分钟心率恢复与远期预后的相关性分析
- Author:
Weiao YANG
;
Shengyu QI
- From:
Chinese Journal of Postgraduates of Medicine
2021;44(1):29-34
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the correlation between heart rate recovery at 1 min after exercise (HRR 1) and long-term prognosis in patients with acute myocardial infarction treated by percutaneous coronary intervention (PCI). Methods:The clinical data of 117 acute myocardial infarction patients who successfully underwent PCI in Qingdao Starr Heart Hospital from May 2014 to May 2017 were retrospectively analyzed. The patients were performed cardiopulmonary exercising test within 30 d after PCI, the peak heart rate (HR peak), resting heart rate, peak oxygen uptake (VO 2peak) were detected, and the HRR 1, heart rate reserve and oxygen pulse were calculated. The correlation between HRR 1 and cardiopulmonary exercise related indexes was analyzed. The incidence of major adverse cardiovascular events (MACE) was recorded 3 years after PCI. The risk factors affecting the prognosis in patients with acute myocardial infarction were analyzed by Cox regression. Results:Among 117 patients, HRR 1 didn′t decrease in 74 cases (non-reduced group), and HRR 1 decreased in 43 cases (reduced group). The proportion of Killip heart function grade Ⅱ to Ⅲ, proportion of triple coronary artery lesions, Gensini score, resting heart rate and oxygen pulse in reduced group were significantly higher than those in non-reduced group: 90.7% (39/43) vs. 70.3% (52/74), 53.5% (23/43) vs. 17.6% (13/74), (81.46 ± 21.55) scores vs. (58.06 ± 17.52) scores, (81.48 ± 11.17) times/min vs. (69.06 ± 10.10) times/min and (13.13 ± 2.93) times/min vs. (9.19 ± 3.06) times/min, the VO 2peak, HR peak, HRR 1 and heart rate reserve were significantly lower than those in non-reduced group: (20.19 ± 9.39) ml/(kg·min) vs. (26.38 ± 9.40) ml/(kg·min), (124.98 ± 22.79) times/min vs. (149.47 ± 22.88) times/min, (16.63 ± 5.92) times/min vs. (27.24 ± 10.21) times/min and (55.51 ± 10.29) times/min vs. (69.07 ± 12.27) times/min, and there were statistical differences ( P<0.01). Correlation analysis results showed that HRR 1 was positively correlated with heart rate reserve, HR peak, VO 2peak ( r = 0.793, 0.835 and 0.800; P<0.01), and negatively correlated with resting heart rate ( r = -0.748, P<0.01); but there was no correlation between HRR 1 and oxygen pulse ( P>0.05). Twenty-one patients did not complete 3 years′ follow-up, with 8 cases in reduced group and 13 cases in non-reduced group. The incidence of MACE in reduced group was significantly higher than that in non-reduced group: 62.9% (22/35) vs. 13.1% (8/61), and there was statistical difference ( χ2 = 12.546, P<0.01). Multivariate Cox regression analysis result showed that the number of coronary artery lesions and HRR 1 were independent risk factors affecting the prognosis in patients with acute myocardial infarction ( HR = 3.124 and 0.248, 95% CI 1.044 to 9.342 and 0.080 to 0.771, P<0.05). Conclusions:The reduction of HRR 1 is related to the exercise cardiopulmonary index in patients with acute myocardial infarction, which can be used as one of the important predictors of long-term prognosis of patients.
