Comparison of heart rate variability and treadmill exercise score in patients with stable coronary artery disease

Abstract

Depressed heart rate variability (HRV) is associated with increased mortality and morbidity with various forms of heart disease, and the Duke treadmill score (DTS) provides diagnostic and prognostic information for the evaluation of patients with coronary artery disease (CAD). Our study was aimed at assessing any possible correlation between HRV and DTS in stable CAD. We evaluated the correlation between the HRV assessed by using 24 hour ambulatory ECG monitoring, and treadmill exercise score in 37 patients with angiographically proven and clinically stable CAD. In univariate analysis, DTS showed a significant negative correlation with age (r = −0.89, p < 0.01) and a significant positive correlation with the square root of the mean of the sum of the squares of differences between adjacent R-R intervals (RMSSD) (r = 0.67, P < 0.05), percent difference between adjacent normal R-R intervals >50 ms (PNN50) (r = 0.69, P < 0.05), and mean of the standard deviation of all R-R intervals in all the 5-minute intervals (HRVM) (r = 0.63, P < 0.05). There is no significant correlation between DTS and standard deviation of all R-R intervals (SDNN), standard deviation of the averages of R-R intervals in all 5-minute segments of the entire recordings (SDANN) and standard deviation of the SDNN in all the 5-minute intervals (HRVSD). In multiple regression analysis, age was the only independent significant predictor of DTS (p < 0.01). DTS decreased with advancing age. SDNN, SDANN, RMSSD, HRVM and HRVSD were not apparent predictors for detecting of DTS. Age was an independent predictor of DTS. Although DTS was correlated with RMSSD, PNN50 and HRVM in patients with stable CAD, time domain parameters of HRV were not appearent predictor for DTS.