摘要
To evaluate the values of abnormal heart rate recovery （HRR） after treadmill exercise test in patients with coronary artery disease （CAD）. Methods One hundred and seventy-eight consecutive cases of suspected CAD who underwent symptom-limited treadmill exercise test （TET） and coronary angiography （CAG） were enrolled and divided into normal and abnormal HRR group based on the status of the values of HRR one or two minutes after TET. The clinical characteristics, TET parameters and CAG results of the two groups were compared attempted to assess the value of HRR on patients with CAD. Results （ 1 ） The cases of smoking, diabetes mellitus （DM） and ST segment deviation at rest in abnormal HRR group were more significantly than those in normal HRR group （ all P 〈 0. 05 ）. （2） The subjects of abnormal HRR usually had higher basal heart rate, more cases exhibited ST segment abnormality and or exercise-limited angina during or after TET（P 〈 0. 01 and P 〈 0. 05, respectively）, but lower level of peak heart rate attained （ P 〈 0. 05 ） than those in normal group. The values of metabolism equivalents and duration of TET between the two groups displayed phenomenal difference （ P 〈 0. 05 ）. There were more samples acquired moderate to high level of Duke test score and chronotropic incompetence in the group of abnormal HRR, compared to the normal HRR group （P 〈 0. 01 ）. （3） The cases of negative CAG results in the group of normal and abnormal HRR group were 73 （66. 97 % ） and 24 （34. 78 % ）. Cases of significant coronary lesions （ at least one major coronary vessel ≥ 50 % stenosis） amongst the subgroup of positive CAG were 36 （ 33.03 % ） and 45 （65.22 % ）, severe coronary lesions （ three-vessel, left main or the equivalents of left main） were 10 （9. 17 % ） and 17 （24. 64 % ） for normal and abnormal HRR respectively （P 〈 0. 01 ）. Accordingly, the Gensini scores in the subunit of abnormal HRR increased. （4）Linear correlation analysis indicate there was a negative correlation between the values of HRR in the first and second minutes and indices of severity of CAD （ all P 〈 0. 01 ）. The analysis of auxiliary diagnostic value of abnormal HRR indicated the annexed HRR standard had higher negative predictive value. Conclusions The status of HRR after TET are not only influenced by the clinical factors related to the cardiac autonomic function, but also associated with the extent of CAD. （ S Chin J Cardiol 2009 ; 10（1）：1-8）
To evaluate the values of abnormal heart rate recovery （HRR） after treadmill exercise test in patients with coronary artery disease （CAD）. Methods One hundred and seventy-eight consecutive cases of suspected CAD who underwent symptom-limited treadmill exercise test （TET） and coronary angiography （CAG） were enrolled and divided into normal and abnormal HRR group based on the status of the values of HRR one or two minutes after TET. The clinical characteristics, TET parameters and CAG results of the two groups were compared attempted to assess the value of HRR on patients with CAD. Results （ 1 ） The cases of smoking, diabetes mellitus （DM） and ST segment deviation at rest in abnormal HRR group were more significantly than those in normal HRR group （ all P 〈 0. 05 ）. （2） The subjects of abnormal HRR usually had higher basal heart rate, more cases exhibited ST segment abnormality and or exercise-limited angina during or after TET（P 〈 0. 01 and P 〈 0. 05, respectively）, but lower level of peak heart rate attained （ P 〈 0. 05 ） than those in normal group. The values of metabolism equivalents and duration of TET between the two groups displayed phenomenal difference （ P 〈 0. 05 ）. There were more samples acquired moderate to high level of Duke test score and chronotropic incompetence in the group of abnormal HRR, compared to the normal HRR group （P 〈 0. 01 ）. （3） The cases of negative CAG results in the group of normal and abnormal HRR group were 73 （66. 97 % ） and 24 （34. 78 % ）. Cases of significant coronary lesions （ at least one major coronary vessel ≥ 50 % stenosis） amongst the subgroup of positive CAG were 36 （ 33.03 % ） and 45 （65.22 % ）, severe coronary lesions （ three-vessel, left main or the equivalents of left main） were 10 （9. 17 % ） and 17 （24. 64 % ） for normal and abnormal HRR respectively （P 〈 0. 01 ）. Accordingly, the Gensini scores in the subunit of abnormal HRR increased. （4）Linear correlation analysis indicate there was a negative correlation between the values of HRR in the first and second minutes and indices of severity of CAD （ all P 〈 0. 01 ）. The analysis of auxiliary diagnostic value of abnormal HRR indicated the annexed HRR standard had higher negative predictive value. Conclusions The status of HRR after TET are not only influenced by the clinical factors related to the cardiac autonomic function, but also associated with the extent of CAD. （ S Chin J Cardiol 2009 ; 10（1）：1-8）
