ArticleJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology2022
Prognostic value of heart rate reserve in patients with suspected coronary artery disease undergoing stress myocardial perfusion imaging.
Article in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 6 citations in OpenAlex.
- Age-Stratified Prognostic Comparison of Three Chronotropic Incompetence Definitions in Patients with Suspected Coronary Artery Disease Undergoing Exercise Stress SPECT-MPI.Clinical interventions in aging · 2026Article
- Interaction of impaired myocardial flow reserve and extent of myocardial ischemia assessed usingJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Article
- Review of cardiovascular imaging in the Journal of Nuclear Cardiology 2022: single photon emission computed tomography.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Review
- The incremental significance of heart rate recovery as a predictor during exercise-stress myocardial perfusion SPECT imaging in individuals with suspected coronary artery disease.Frontiers in cardiovascular medicine · 2023Article
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Authors and funding
13 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundChronotropic incompetence is common in patients with cardiovascular disease and is associated with increased risk of adverse events. We assessed the incremental prognostic value of heart rate reserve (HRR) over stress myocardial perfusion single-photon emission computed tomography (MPS) findings in patients with suspected coronary artery disease (CAD).
methodsWe studied 866 patients with suspected CAD undergoing exercise stress-MPS as part of their diagnostic program. The primary study endpoint was all-cause mortality. All patients were followed for at least 5 years. HRR was calculated as the difference between peak exercise and resting HR, divided by the difference of age-predicted maximal and resting HR and expressed as percentage.
resultsDuring 7 years follow-up, 61 deaths occurred, with a 7% cumulative event rate. Patients experiencing death were older (P < .001), and had a higher prevalence of male gender (P < .001) and diabetes (P < .05). Patients with event also had lower values of HRR (65% ± 27% vs 73% ± 18%, P < .0001) and higher prevalence of stress-induced myocardial ischemia (25% vs 8%, P < .0001). Male gender, HRR and stress-induced ischemia were independent predictors of all-cause mortality (all P < .01). HRR improved the prognostic power of a model including clinical data and MPS findings, increasing the global χ
conclusionsChronotropic incompetence has independent and incremental prognostic value in predicting all-cause mortality in patients with suspected CAD undergoing exercise stress-MPS. Hence, the evaluation of HRR may further improve patients' risk stratification.
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