ArticleAmerican journal of physiology. Heart and circulatory physiology2012
QT-RR hysteresis is caused by differential autonomic states during exercise and recovery.
Article in American journal of physiology. Heart and circulatory physiology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 3 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 3 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- Brazilian Guideline for Exercise Test in the Adult Population - 2024.Arquivos brasileiros de cardiologia · 2024Guideline
- Comparison of methods for correcting QT interval in athletes and young people: A systematic review.Clinical cardiology · 2023Pooled it
- Clinical applications of QT/RR hysteresis assessment: A systematic review.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2018Pooled it
- Beyond the QT interval: how QT/RR hysteresis may reveal a sex-dependent hidden risk for cardiac arrhythmias.American journal of physiology. Heart and circulatory physiology · 2025Article
- Advanced ECG Analysis to Evaluate Multimodal Exercise Effects on Cardiovascular Health.Medicina (Kaunas, Lithuania) · 2025Article
- Accurate QT correction method from transfer entropy.Cardiovascular digital health journal · 2023Article
- The role of β-adrenergic stimulation in QT interval adaptation to heart rate during stress test.PloS one · 2023Article
- Exercise based assessment of cardiac autonomic function in type 1 versus type 2 diabetes mellitus.Cardiology journal · 2022Article
- Sex and Rate Change Differences in QT/RR Hysteresis in Healthy Subjects.Frontiers in physiology · 2021Article
- Categorization and theoretical comparison of quantitative methods for assessing QT/RR hysteresis.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2017Review
- The high frequency relationship: implications for torsadogenic hERG blockers.British journal of pharmacology · 2016Article
- Heart-rate-corrected QT interval evolution in premature infants during the first week of life.Pediatric cardiology · 2014Article
- Cardiac electrical conduction, autonomic activity and biomarker release during recovery from prolonged strenuous exercise in trained male cyclists.European journal of applied physiology · 2014Article
- QT Interval and Cardiac Restitution Ratio Complexity in Standardbred Racehorses From Rest to Maximal Effort: Insights Into Arrhythmia Risk.Journal of veterinary internal medicineArticle
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
QT-RR hysteresis is characterized by longer QT intervals at a given RR interval while heart rates are increasing during exercise and shorter QT intervals at the same RR interval while heart rates are decreasing during recovery. It has been attributed to a lagging QT response to different directional changes in RR interval during exercise and recovery. Twenty control subjects (8 males, age 51 ± 6 yr), 16 subjects with type 2 diabetes (12 males, age 56 ± 8 yr), 71 subjects with coronary artery disease (CAD) and preserved left ventricular ejection fraction (LVEF) (≥50%) (51 males, age 59 ± 12 yr), and 17 CAD subjects with depressed LVEF (<50%) (13 males, age 57 ± 10 yr) underwent two 16-min exercise tests followed by recovery. In session 2, parasympathetic blockade with atropine (0.04 mg/kg) was achieved at end exercise. QT-RR hysteresis was quantified as: 1) the area bounded by the QT-RR relationships for exercise and recovery in the range of the minimum RR interval at peak exercise to the minimum RR interval + 100 ms and 2) the difference in QT interval duration between exercise and recovery at the minimum RR interval achieved during peak exercise plus 50 ms (ΔQT). The effect of parasympathetic blockade was assessed by substituting the QT-RR relationship after parasympathetic blockade. QT-RR hysteresis was positive in all groups at baseline and reversed by parasympathetic blockade (P < 0.01). We conclude that QT-RR hysteresis is not caused by different directional changes in RR interval during exercise and recovery. Instead, it is predominantly mediated by differential autonomic nervous system effects as the heart rate increases during exercise vs. as it decreases during recovery.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.