Article

Both impaired heart rate recovery (HRR) and low fitness are
associated with higher mortality risk. In addition, HRR is influenced by fitness
status. The interaction between HRR, mortality, and fitness has not been clearly
defined. Thus, we sought to evaluate the association between HRR and all-cause
mortality and to assess the effects of fitness on this association. METHODS:
Treadmill exercise testing was performed in 5974 male veterans for clinical
reasons at two Veterans Affairs Medical Centers (Washington, DC and Palo Alto,
CA). HRR was calculated at 1 and 2 min of recovery. All-cause mortality was
determined over a mean 6.2-year follow-up period. RESULTS: Mortality risk was
significantly and inversely associated with HRR, only at 2 min. A cut-off value
of 14 beats/min at 2 min recovery was the strongest predictor of mortality for
the cohort (hazard ratio = 2.4; CI 1.6-3.5). The mortality risk was overestimated
when exercise capacity was not considered. When both low fitness and low HRR were
present (</=6 metabolic equivalents and </=14 beats/min), mortality risk was
approximately seven-fold higher compared to the High-fit + High-HRR group (>6
metabolic equivalents and >14 beats/min). CONCLUSIONS: HRR at 2 min post exercise
is strongly and inversely associated with all-cause mortality. Exercise capacity
affects HRR-associated mortality substantially and should be considered when
applying HRR to estimate mortality.

Langue : ANGLAIS