The relation between heart rate response during exercise and angiographic severity in patients with chronic coronary syndrome

Article Type

Original Study

Subject Area

Cardiology

Abstract

Introduction Ellestad and colleagues, in 1975, reached to the conclusion that impaired heart rate response to exercise carries a similar risk for future coronary events such as ischemic ‘ST’ segment changes. Mc Neer and colleagues went beyond these observations to include a survival benefit in patients who achieve a higher peak heart rate (PHR), a more advanced level of exercise, and have a normal exercise electrocardiogram. Aim The aim of this work is to clarify the relation between the chronotropic response to exercise and the severity of coronary artery disease in patients with chronic coronary syndrome. Patients and methods The study was carried out in the National Heart Institute during the period from May 2019 to March 2020 on 44 patients with clinical suspicion or ECG evidence of chronic coronary syndrome in addition to 10 normal participants as a control group. All patients and control persons were subjected to Full history taking, including personal history, past history, and family history, as well as history of hypertension, diabetes mellitus, and dyslipidemia. Complete general and local cardiac examination. Resting 12-lead ECG. Exercise stress test. Determination of chronotropic response during exercise test: PHR. It is the maximal heart rate achieved during exercise. The percent maximal age-predicted heart rate (PCT): PCT=PHR/(220−age in years)×100 The chronotropic index (CI): CI=(% HRR)2/(% MR)2 where (HRR)2=Heart rate reserve at the end of the second stage. (MR)2=Metabolic reserve at the end of the second stage where % HRR stage={(HR stage–HR rest)/(maximum age-predicted HR–HR rest)}×100% MR stage={(METs stage–METs rest)/(METs peak–METs rest)}×100. Patients with positive exercise test were subjected to coronary angiography.

Recommended Citation

Louka, Emmanuel (2023) "The relation between heart rate response during exercise and angiographic severity in patients with chronic coronary syndrome," Journal of Medicine in Scientific Research: Vol. 6: Iss. 2, Article 2.
DOI: https://doi.org/10.59299/2537-0928.1016