European Heart Journal Advance Access originally published online on March 14, 2006
European Heart Journal 2006 27(8):954-959; doi:10.1093/eurheartj/ehi832
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Chronotropic response to exercise testing is associated with carotid atherosclerosis in healthy middle-aged men
1Exercise and Cardiovascular Research Laboratory, Department of Kinesiology and Community Health, College of Applied Life Studies, University of Illinois, Urbana-Champaign, 112 Huff Hall, MC-586, 1206 S. Fourth St Champaign, IL 61820
2Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, South Korea
3Center for Health Promotion and Sports Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Received 26 September 2005; revised 9 February 2006; accepted 23 February 2006; online publish-ahead-of-print 14 March 2006.
* Corresponding author. Tel: +1 217 333 2131; fax: +1 217 333 0404. E-mail address: fernhall{at}uiuc.edu
See page 897 for the editorial comment on this article (doi:10.1093/eurheartj/ehi712)
Aims Chronotropic incompetence, an attenuated heart rate (HR) response to exercise, is an independent predictor of cardiovascular mortality, but it is not known whether chronotropic incompetence is related to carotid atherosclerosis. The association between chronotropic incompetence and carotid atherosclerosis in 8567 (age 47.6±8.8 years) healthy men was examined.
Methods and results Chronotropic incompetence was defined as the failure to achieve 85% of the age-predicted maximal HR (APMHR), <80% HR reserve (HRR), and chronotropic response index (CRI). Carotid atherosclerosis was defined, using B-mode ultrasonography, as stenosis >25% and/or intima-media thickness (IMT) of >1.2 mm. In multivariable adjusted logistic regression models, the subjects who achieved less than 85% of APMHR exhibited an odds ratio (OR) of 1.72 [95% confidence intervals (CI): 1.32–2.22] for carotid atherosclerosis. Subjects with <80% of HRR were 1.45 (95% CI: 1.14–1.84) times more likely to have carotid atherosclerosis after multivariate adjustment. Also, the OR of carotid atherosclerosis across quartiles of CRI (highest to lowest) was 1.51 (95% CI: 1.10–2.09) after multivariate adjustment.
Conclusion These results suggest that the chronotropic response to exercise is associated with carotid atherosclerosis, independent of the established risk factors in healthy men, which could contribute to high incidence of cardiovascular diseases in subjects with chronotropic incompetence.
Key Words: Chronotropic incompetence • Carotid • Atherosclerosis • Exercise testing • Heart rate
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