title: Effects of fasting and/or postprandial glucose on heart rate recovery in patients with coronary heart disease.
abstract: OBJECTIVE
  The impact of both fasting and postprandial glycaemia on heart rate recovery (HRR) has not been studied in patients with coronary heart disease (CHD). For this reason, we sought to determine the relationships between HRR and both fasting and postprandial glycaemia.
  
  
  METHODS
  A total of 4079 patients with baseline fasting plasma glucose (FPG) levels and 706 patients with 2-hour postprandial glucose (2hPG) levels were identified from the Coronary Artery Surgery Study registry, a database of 24,958 patients with suspected or proven CHD who had undergone cardiac catheterization between 1974 and 1979. Median long-term follow-up was 14.7 years (interquartile range: 9.8-16.2 years). The relationships between HRR and both FPG and 2hPG were studied.
  
  
  RESULTS
  In univariate analyses, increasing levels of both FPG and 2hPG were significantly associated with lower HRR. In multivariate models adjusted for age, exercise tolerance in METs, resting heart rate and maximum systolic blood pressure during exercise testing, FPG remained significantly associated with HRR while 2hPG did not.
  
  
  CONCLUSIONS
  Both raised FPG and decreased HRR are independent predictors of total and cardiovascular (CV) mortality in subjects with CHD. Our data suggest that the mortality risk associated with elevated FPG may in part be due to deleterious effects on autonomic regulation of CV function, as reflected by lower HRR. Further studies are required to determine whether or not non-pharmacological and/or pharmacological treatments of increased fasting glucose have a beneficial influence on HRR.
authors.affiliation: Montreal Heart Institute, Cardiovascular Prevention and Rehabilitation Center (Centre ÉPIC), Université de Montréal, Montreal, Quebec, H1T1C8, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Gayda
authors.forename: M G
authors.initials: MG
authors.lastname: Bourassa
authors.forename: J C
authors.initials: JC
authors.lastname: Tardif
authors.forename: A
authors.initials: A
authors.lastname: Fortier
authors.forename: M
authors.initials: M
authors.lastname: Juneau
authors.forename: A
authors.initials: A
authors.lastname: Nigam
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D002170:Canada / Q000453:epidemiology; D003324:Coronary Artery Disease / Q000097:blood* / Q000401:mortality / Q000503:physiopathology; D005080:Exercise Test; D005215:Fasting / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin