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Abnormal Heart Rate Recovery Tied to Higher Mortality

Last Updated: September 27, 2011.

Abnormal heart rate recovery (HRR) after undergoing a cardiac rehabilitation exercise program is associated with higher all-cause mortality, but patients who had abnormal HRR at baseline and normalized HRR after completing the program have similar mortality to patients with a normal baseline HRR, according to a study published online Sept. 26 in Circulation.

TUESDAY, Sept. 27 (HealthDay News) -- Abnormal heart rate recovery (HRR) after undergoing a cardiac rehabilitation (CR) exercise program is associated with higher all-cause mortality, but patients who had abnormal HRR at baseline and normalized HRR after completing the program have similar mortality to patients with a normal baseline HRR, according to a study published online Sept. 26 in Circulation.

Michael Jolly, M.D., from the Cleveland Clinic, and colleagues examined whether CR improves HRR and whether it is associated with all-cause mortality. A total of 1,070 patients (544 with an abnormal baseline HRR) underwent exercise stress testing before and after completion of a phase 2 CR program. HRR and mortality were examined as the primary end points.

The investigators identified 225 patients (41 percent) with abnormal HRR at baseline but who had normal HRR after undergoing CR. A total of 197 patients in the cohort died (18 percent). For patients with an abnormal HRR at baseline, failure to normalize HRR after CR was found to be a significant predictor of higher mortality. For all patients, the presence of an abnormal HRR at exit was predictive of death, after adjusting for multiple variables (hazard ratio, 2.15). Similar survival rates were seen for patients with abnormal HRR at baseline who normalized after CR and those with normal HRR at baseline.

"There was a strong association of abnormal HRR at exit with all-cause mortality. Patients with abnormal HRR at baseline who normalized HRR with exercise had a mortality similar to that of individuals with baseline normal HRR," the authors write.

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