Heart Rate Recovery After Exercise Is a Predictor of Silent Myocardial Ischemia in Patients With Type 2 Diabetes

  1. Fumihiko Saeki, MD, PHD
  1. Department of Cardiology, Toshiba Hospital, Tokyo, Japan
  1. Corresponding author: Tomohide Yamada, bqx07367{at}yahoo.co.jp.


OBJECTIVE Slow heart rate recovery (HRR) predicts all-cause mortality. This study investigated the relationship between silent myocardial ischemia (SMI) and HRR in type 2 diabetes.

RESEARCH DESIGN AND METHODS The study enrolled 87 consecutive patients with type 2 diabetes and no chest symptoms. They underwent treadmill exercise testing and single-photon emission computed tomography imaging with thallium scintigraphy. Patients with abnormal myocardial perfusion images also underwent coronary angiography.

RESULTS SMI was diagnosed in 41 patients (47%). The SMI group showed slower HRR than the non–SMI group (18 ± 6 vs. 30 ± 12 bpm; P < 0.0001). HRR was significantly associated with SMI (odds ratio 0.83 [95% CI 0.75–0.92]; P = 0.0006), even after adjustment for maximal exercise workload, resting heart rate, maximum heart rate, rate pressure product, HbA1c, use of sulfonamides, and a history of cardiovascular disease.

CONCLUSIONS HRR can predict SMI in patients with type 2 diabetes.

  • Received July 23, 2010.
  • Accepted December 8, 2010.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.

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  1. Diabetes Care vol. 34 no. 3 724-726
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