Heart rate recovery after exercise is a predictor of silent myocardial ischemia in patients with type 2 diabetes.
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.


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, HbA(1c), use of sulfonamides, and a history of cardiovascular disease.


CONCLUSIONS
HRR can predict SMI in patients with type 2 diabetes.
Department of Cardiology, Toshiba Hospital, Tokyo, Japan. bqx07367@yahoo.co.jp
Tomohide
T
Yamada
Takashi
T
Yoshitama
Kunihiko
K
Makino
Tetsuo
T
Lee
Fumihiko
F
Saeki
D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis*
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