Background The increase in heart rate that accompanies exerciseis due in part to a reduction in vagal tone. Recovery of theheart rate immediately after exercise is a function of vagalreactivation. Because a generalized decrease in vagal activityis known to be a risk factor for death, we hypothesized thata delayed fall in the heart rate after exercise might be animportant prognostic marker.
Methods For six years we followed 2428 consecutive adults (mean[±SD] age, 57±12 years; 63 percent men) withouta history of heart failure or coronary revascularization andwithout pacemakers. The patients were undergoing symptom-limitedexercise testing and single-photon-emission computed tomographywith thallium scintigraphy for diagnostic purposes. The valuefor the recovery of heart rate was defined as the decrease inthe heart rate from peak exercise to one minute after the cessationof exercise. An abnormal value for the recovery of heart ratewas defined as a reduction of 12 beats per minute or less fromthe heart rate at peak exercise.
Results There were 213 deaths from all causes. A total of 639patients (26 percent) had abnormal values for heart-rate recovery.In univariate analyses, a low value for the recovery of heartrate was strongly predictive of death (relative risk, 4.0; 95percent confidence interval, 3.0 to 5.2; P<0.001). Afteradjustments were made for age, sex, the use or nonuse of medications,the presence or absence of myocardial perfusion defects on thalliumscintigraphy, standard cardiac risk factors, the resting heartrate, the change in heart rate during exercise, and workloadachieved, a low value for heart-rate recovery remained predictiveof death (adjusted relative risk, 2.0; 95 percent confidenceinterval, 1.5 to 2.7; P<0.001).
Conclusions A delayed decrease in the heart rate during thefirst minute after graded exercise, which may be a reflectionof decreased vagal activity, is a powerful predictor of overallmortality, independent of workload, the presence or absenceof myocardial perfusion defects, and changes in heart rate duringexercise.
Source Information
From the Departments of Cardiology (C.R.C., F.J.P., C.E.S., M.S.L.), Cardiothoracic Surgery (E.H.B.), and Epidemiology and Biostatistics (E.H.B.) and the George M. and Linda H. Kaufman Center for Heart Failure (M.S.L.), Cleveland Clinic Foundation, Cleveland.
Address reprint requests to Dr. Lauer at the Section of Heart Failure and Cardiac Transplantation Medicine, Department of Cardiology, Desk F25, Cleveland Clinic Foundation, 9500 Euclid Ave., Cleveland, OH 44195, or at lauerm{at}ccf.org.
Exercise Capacity and Mortality
Palatini P., Ko D. T., Hebert P. R., Krumholz H. M., Perlo D. H., Myers J., Froelicher V., Balady G. J.
Extract |
Full Text |
PDF
N Engl J Med 2002;
347:288-290, Jul 25, 2002.
Correspondence
This article has been cited by other articles:
Fourlas, C. A.
(2009). Resting heart rate and excessive heart rate increase during pre-exercise mental stress: which one predicts mortality?. Eur Heart J
30: 2815-2815
[Full Text]
Ng, J., Sundaram, S., Kadish, A. H., Goldberger, J. J.
(2009). Autonomic effects on the spectral analysis of heart rate variability after exercise. Am. J. Physiol. Heart Circ. Physiol.
297: H1421-H1428
[Abstract][Full Text]
Kesoi, I., Sagi, B., Vas, T., Kovacs, T., Wittmann, I., Nagy, J.
(2009). Heart rate recovery after exercise is associated with renal function in patients with a homogenous chronic renal disease. Nephrol Dial Transplant
0: gfp504v1-gfp504
[Abstract][Full Text]
Poulter, N. R., Dobson, J. E., Sever, P. S., Dahlof, B., Wedel, H., Campbell, N. R.C., on behalf of the ASCOT Investigators,
(2009). Baseline heart rate, antihypertensive treatment, and prevention of cardiovascular outcomes in ASCOT (Anglo-Scandinavian Cardiac Outcomes Trial).. J Am Coll Cardiol
54: 1154-1161
[Abstract][Full Text]
Swigris, J. J., Swick, J., Wamboldt, F. S., Sprunger, D., du Bois, R., Fischer, A., Cosgrove, G. P., Frankel, S. K., Fernandez-Perez, E. R., Kervitsky, D., Brown, K. K.
(2009). Heart Rate Recovery After 6-Min Walk Test Predicts Survival in Patients With Idiopathic Pulmonary Fibrosis. Chest
136: 841-848
[Abstract][Full Text]
Chicos, A. B., Kannankeril, P. J., Kadish, A. H., Goldberger, J. J.
(2009). Parasympathetic effects on cardiac electrophysiology during exercise and recovery in patients with left ventricular dysfunction. Am. J. Physiol. Heart Circ. Physiol.
297: H743-H749
[Abstract][Full Text]
Jouven, X., Schwartz, P. J., Escolano, S., Straczek, C., Tafflet, M., Desnos, M., Empana, J. P., Ducimetiere, P.
(2009). Excessive heart rate increase during mild mental stress in preparation for exercise predicts sudden death in the general population. Eur Heart J
30: 1703-1710
[Abstract][Full Text]
Boettger, S., Wetzig, F., Puta, C., Donath, L., Muller, H.-J., Gabriel, H. H. W., Bar, K.-J.
(2009). Physical Fitness and Heart Rate Recovery Are Decreased in Major Depressive Disorder. Psychosom. Med.
71: 519-523
[Abstract][Full Text]
LAUER, M. S.
(2009). Autonomic function and prognosis. Cleveland Clinic Journal of Medicine
76: S18-S22
[Abstract][Full Text]
Bauer, A., Barthel, P., Schneider, R., Ulm, K., Muller, A., Joeinig, A., Stich, R., Kiviniemi, A., Hnatkova, K., Huikuri, H., Schomig, A., Malik, M., Schmidt, G.
(2009). Improved Stratification of Autonomic Regulation for risk prediction in post-infarction patients with preserved left ventricular function (ISAR-Risk). Eur Heart J
30: 576-583
[Abstract][Full Text]
Herring, N., Paterson, D. J.
(2009). Neuromodulators of peripheral cardiac sympatho-vagal balance. Exp Physiol
94: 46-53
[Abstract][Full Text]
Gielen, S., Mezzani, A., Hambrecht, R., Saner, H.
(2009). CHAPTER 25 Cardiac Rehabilitation. ESC Textbook of Cardiovascular Medicine
2: med-9780199566990-chapter-med-9780199566990-chapter
[Abstract][Full Text]
Arena, R., Myers, J., Guazzi, M.
(2008). The Clinical Significance of Aerobic Exercise Testing and Prescription: From Apparently Healthy to Confirmed Cardiovascular Disease. AMERICAN JOURNAL OF LIFESTYLE MEDICINE
2: 519-536
[Abstract]
Goldberger, J. J., Cain, M. E., Hohnloser, S. H., Kadish, A. H., Knight, B. P., Lauer, M. S., Maron, B. J., Page, R. L., Passman, R. S., Siscovick, D., Stevenson, W. G., Zipes, D. P.
(2008). American Heart Association/American College of Cardiology Foundation/Heart Rhythm Society Scientific Statement on Noninvasive Risk Stratification Techniques for Identifying Patients at Risk for Sudden Cardiac Death: A Scientific Statement From the American Heart Association Council on Clinical Cardiology Committee on Electrocardiography and Arrhythmias and Council on Epidemiology and Prevention. J Am Coll Cardiol
52: 1179-1199
[Full Text]
Goldberger, J. J., Cain, M. E., Hohnloser, S. H., Kadish, A. H., Knight, B. P., Lauer, M. S., Maron, B. J., Page, R. L., Passman, R. S., Siscovick, D., Stevenson, W. G., Zipes, D. P.
(2008). American Heart Association/American College of Cardiology Foundation/Heart Rhythm Society Scientific Statement on Noninvasive Risk Stratification Techniques for Identifying Patients at Risk for Sudden Cardiac Death: A Scientific Statement From the American Heart Association Council on Clinical Cardiology Committee on Electrocardiography and Arrhythmias and Council on Epidemiology and Prevention. Circulation
118: 1497-1518
[Full Text]
Vanhecke, T. E., Franklin, B. A., Zalesin, K. C., Sangal, R. B., deJong, A. T., Agrawal, V., McCullough, P. A.
(2008). Cardiorespiratory Fitness and Obstructive Sleep Apnea Syndrome in Morbidly Obese Patients. Chest
134: 539-545
[Abstract][Full Text]
Unverdorben, M., van der Bijl, A., Potgieter, L., Venter, C., Munjal, S., Qiwei Liang, , Meyer, B., Rothig, H.-J.
(2008). Effects of Different Levels of Cigarette Smoke Exposure on Prognostic Heart Rate and Rate--Pressure-Product Parameters. J CARDIOVASC PHARMACOL THER
13: 175-182
[Abstract]
Dawson, T. A., Li, D., Woodward, T., Barber, Z., Wang, L., Paterson, D. J.
(2008). Cardiac cholinergic NO-cGMP signaling following acute myocardial infarction and nNOS gene transfer. Am. J. Physiol. Heart Circ. Physiol.
295: H990-H998
[Abstract][Full Text]
Palatini, P.
(2008). Exercise testing in asymptomatic subjects: from diagnostic test to prognostic tool?. Eur Heart J
29: 1803-1806
[Full Text]
LAUER, M. S., MILLER, T. D.
(2008). The exercise treadmill test: Estimating cardiovascular prognosis. Cleveland Clinic Journal of Medicine
75: 424-430
[Abstract][Full Text]
Soleimani, A., Salarifar, M., Kasaian, S. E, Sadeghian, S., Nejatian, M., Abbasi, A.
(2008). Effect of Completion of Cardiac Rehabilitation on Heart Rate Recovery. Asian Cardiovasc. Thorac. Ann.
16: 202-207
[Abstract][Full Text]
Lahiri, M. K., Kannankeril, P. J., Goldberger, J. J.
(2008). Assessment of Autonomic Function in Cardiovascular Disease: Physiological Basis and Prognostic Implications. J Am Coll Cardiol
51: 1725-1733
[Abstract][Full Text]
Syme, C., Abrahamowicz, M., Leonard, G. T., Perron, M., Pitiot, A., Qiu, X., Richer, L., Totman, J., Veillette, S., Xiao, Y., Gaudet, D., Paus, T., Pausova, Z.
(2008). Intra-abdominal Adiposity and Individual Components of the Metabolic Syndrome in Adolescence: Sex Differences and Underlying Mechanisms. Arch Pediatr Adolesc Med
162: 453-461
[Abstract][Full Text]
Lin, L.-Y., Kuo, H.-K., Lai, L.-P., Lin, J.-L., Tseng, C.-D., Hwang, J.-J.
(2008). Inverse Correlation Between Heart Rate Recovery and Metabolic Risks in Healthy Children and Adolescents: Insight from the National Health and Nutrition Examination Survey 1999-2002. Diabetes Care
31: 1015-1020
[Abstract][Full Text]
Hughes, J. W., York, K. M., Li, Q., Freedland, K. E., Carney, R. M., Sheps, D. S.
(2008). Depressive Symptoms Predict Heart Rate Recovery After Exercise Treadmill Testing in Patients With Coronary Artery Disease: Results From the Psychophysiological Investigations of Myocardial Ischemia Study. Psychosom. Med.
70: 456-460
[Abstract][Full Text]
Dewey, F. E., Kapoor, J. R., Williams, R. S., Lipinski, M. J., Ashley, E. A., Hadley, D., Myers, J., Froelicher, V. F.
(2008). Ventricular Arrhythmias During Clinical Treadmill Testing and Prognosis. Arch Intern Med
168: 225-234
[Abstract][Full Text]
Sundaram, S., Carnethon, M., Polito, K., Kadish, A. H., Goldberger, J. J.
(2008). Autonomic effects on QT-RR interval dynamics after exercise. Am. J. Physiol. Heart Circ. Physiol.
294: H490-H497
[Abstract][Full Text]
Lauer, M. S., Pothier, C. E., Magid, D. J., Smith, S. S., Kattan, M. W.
(2007). An Externally Validated Model for Predicting Long-Term Survival after Exercise Treadmill Testing in Patients with Suspected Coronary Artery Disease and a Normal Electrocardiogram. ANN INTERN MED
147: 821-828
[Abstract][Full Text]
Spielmann, N., Leon, A. S., Rao, D. C., Rice, T., Skinner, J. S., Rankinen, T., Bouchard, C.
(2007). Genome-wide linkage scan for submaximal exercise heart rate in the HERITAGE family study. Am. J. Physiol. Heart Circ. Physiol.
293: H3366-H3371
[Abstract][Full Text]
Kim, E. S.H., Ishwaran, H., Blackstone, E., Lauer, M. S.
(2007). External Prognostic Validations and Comparisons of Age- and Gender-Adjusted Exercise Capacity Predictions. J Am Coll Cardiol
50: 1867-1875
[Abstract][Full Text]
Heffernan, K. S., Fahs, C. A., Shinsako, K. K., Jae, S. Y., Fernhall, B.
(2007). Heart rate recovery and heart rate complexity following resistance exercise training and detraining in young men. Am. J. Physiol. Heart Circ. Physiol.
293: H3180-H3186
[Abstract][Full Text]
Buchheit, M., Papelier, Y., Laursen, P. B., Ahmaidi, S.
(2007). Noninvasive assessment of cardiac parasympathetic function: postexercise heart rate recovery or heart rate variability?. Am. J. Physiol. Heart Circ. Physiol.
293: H8-H10
[Full Text]
Dewland, T. A., Androne, A. S., Lee, F. A., Lampert, R. J., Katz, S. D.
(2007). Effect of acetylcholinesterase inhibition with pyridostigmine on cardiac parasympathetic function in sedentary adults and trained athletes. Am. J. Physiol. Heart Circ. Physiol.
293: H86-H92
[Abstract][Full Text]
Buchheit, M., Laursen, P. B., Ahmaidi, S.
(2007). Parasympathetic reactivation after repeated sprint exercise. Am. J. Physiol. Heart Circ. Physiol.
293: H133-H141
[Abstract][Full Text]
Heaton, D. A., Li, D., Almond, S. C., Dawson, T. A., Wang, L., Channon, K. M., Paterson, D. J.
(2007). Gene Transfer of Neuronal Nitric Oxide Synthase into Intracardiac Ganglia Reverses Vagal Impairment in Hypertensive Rats. Hypertension
49: 380-388
[Abstract][Full Text]
Legramante, J. M., Iellamo, F., Massaro, M., Sacco, S., Galante, A.
(2007). Effects of residential exercise training on heart rate recovery in coronary artery patients. Am. J. Physiol. Heart Circ. Physiol.
292: H510-H515
[Abstract][Full Text]
Borlaug, B. A., Melenovsky, V., Russell, S. D., Kessler, K., Pacak, K., Becker, L. C., Kass, D. A.
(2006). Impaired Chronotropic and Vasodilator Reserves Limit Exercise Capacity in Patients With Heart Failure and a Preserved Ejection Fraction. Circulation
114: 2138-2147
[Abstract][Full Text]
Kligfield, P., Lauer, M. S.
(2006). Exercise Electrocardiogram Testing: Beyond the ST Segment. Circulation
114: 2070-2082
[Full Text]
Schubiner, H., Hassunizadeh, B., Kaczynski, R.
(2006). A controlled study of autonomic nervous system function in adults with attention-deficit/hyperactivity disorder treated with stimulant medications: results of a pilot study.. J Atten Disord
10: 205-211
[Abstract]
Steptoe, A., Donald, A. E., O'Donnell, K., Marmot, M., Deanfield, J. E.
(2006). Delayed Blood Pressure Recovery After Psychological Stress Is Associated With Carotid Intima-Media Thickness: Whitehall Psychobiology Study. Arterioscler. Thromb. Vasc. Bio.
26: 2547-2551
[Abstract][Full Text]
Diller, G.-P., Dimopoulos, K., Okonko, D., Uebing, A., Broberg, C. S., Babu-Narayan, S., Bayne, S., Poole-Wilson, P. A., Sutton, R., Francis, D. P., Gatzoulis, M. A.
(2006). Heart Rate Response During Exercise Predicts Survival in Adults With Congenital Heart Disease. J Am Coll Cardiol
48: 1250-1256
[Abstract][Full Text]
Heaton, D. A., Lei, M., Li, D., Golding, S., Dawson, T. A., Mohan, R. M., Paterson, D. J.
(2006). Remodeling of the Cardiac Pacemaker L-Type Calcium Current and Its {beta}-Adrenergic Responsiveness in Hypertension After Neuronal NO Synthase Gene Transfer. Hypertension
48: 443-452
[Abstract][Full Text]
Akgoz, H., Gurkan, U., Dayi, S. U., Terzi, S., Akbulut, T., Torun, A., Tayyareci, G.
(2006). The Relationship Between {beta}-Receptor Sensitivity and Nocturnal Blood Pressure and Heart Rate Recovery in Normotensive People. ANGIOLOGY
57: 495-500
[Abstract]
Giallauria, F., Lucci, R., Pietrosante, M., Gargiulo, G., De Lorenzo, A., D'Agostino, M., Gerundo, G., Abete, P., Rengo, F., Vigorito, C.
(2006). Exercise-based cardiac rehabilitation improves heart rate recovery in elderly patients after acute myocardial infarction.. Journals of Gerontology Series A: Biological Sciences and Medical Sciences
61: 713-717
[Abstract][Full Text]
Steptoe, A., Marmot, M.
(2006). Psychosocial, Hemostatic, and Inflammatory Correlates of Delayed Poststress Blood Pressure Recovery. Psychosom. Med.
68: 531-537
[Abstract][Full Text]
Buchheit, M., Gindre, C.
(2006). Cardiac parasympathetic regulation: respective associations with cardiorespiratory fitness and training load. Am. J. Physiol. Heart Circ. Physiol.
291: H451-H458
[Abstract][Full Text]
Hautala, A. J., Rankinen, T., Kiviniemi, A. M., Makikallio, T. H., Huikuri, H. V., Bouchard, C., Tulppo, M. P.
(2006). Heart rate recovery after maximal exercise is associated with acetylcholine receptor M2 (CHRM2) gene polymorphism. Am. J. Physiol. Heart Circ. Physiol.
291: H459-H466
[Abstract][Full Text]
Goldberger, J. J., Le, F. K., Lahiri, M., Kannankeril, P. J., Ng, J., Kadish, A. H.
(2006). Assessment of parasympathetic reactivation after exercise. Am. J. Physiol. Heart Circ. Physiol.
290: H2446-H2452
[Abstract][Full Text]
Newman, A. B., Simonsick, E. M., Naydeck, B. L., Boudreau, R. M., Kritchevsky, S. B., Nevitt, M. C., Pahor, M., Satterfield, S., Brach, J. S., Studenski, S. A., Harris, T. B.
(2006). Association of Long-Distance Corridor Walk Performance With Mortality, Cardiovascular Disease, Mobility Limitation, and Disability. JAMA
295: 2018-2026
[Abstract][Full Text]
Carnethon, M. R., Prineas, R. J., Temprosa, M., Zhang, Z.-M., Uwaifo, G., Molitch, M. E., for the Diabetes Prevention Program Research Group,
(2006). The Association Among Autonomic Nervous System Function, Incident Diabetes, and Intervention Arm in the Diabetes Prevention Program. Diabetes Care
29: 914-919
[Abstract][Full Text]
Trochim, W. M., Cabrera, D. A., Milstein, B., Gallagher, R. S., Leischow, S. J.
(2006). Practical Challenges of Systems Thinking and Modeling in Public Health. AJPH
96: 538-546
[Abstract][Full Text]
Kawasaki, T, Azuma, A, Kuribayashi, T, Taniguchi, T, Asada, S, Kamitani, T, Kawasaki, S, Matsubara, H, Sugihara, H
(2006). Enhanced vagal modulation and exercise induced ischaemia of the inferoposterior myocardium. Heart
92: 325-330
[Abstract][Full Text]
Shishehbor, M. H., Litaker, D., Pothier, C. E., Lauer, M. S.
(2006). Association of Socioeconomic Status With Functional Capacity, Heart Rate Recovery, and All-Cause Mortality. JAMA
295: 784-792
[Abstract][Full Text]
Albers, A. R., Krichavsky, M. Z., Balady, G. J.
(2006). Stress Testing in Patients With Diabetes Mellitus: Diagnostic and Prognostic Value. Circulation
113: 583-592
[Full Text]
Tarakji, K. G., Brunken, R., McCarthy, P. M., Al-Chekakie, M. O., Abdel-Latif, A., Pothier, C. E., Blackstone, E. H., Lauer, M. S.
(2006). Myocardial Viability Testing and the Effect of Early Intervention in Patients With Advanced Left Ventricular Systolic Dysfunction. Circulation
113: 230-237
[Abstract][Full Text]
Clouse, M. E., Chen, J., Krumholz, H. M., Clouse, M. E., Chen, J., Krumholz, H. M.
(2006). Noninvasive Screening for Coronary Artery Disease With Computed Tomography Is Useful. Circulation
113: 125-146
[Full Text]
Falcone, C., Buzzi, M. P., Klersy, C., Schwartz, P. J.
(2005). Rapid Heart Rate Increase at Onset of Exercise Predicts Adverse Cardiac Events in Patients With Coronary Artery Disease. Circulation
112: 1959-1964
[Abstract][Full Text]
Mora, S., Redberg, R. F., Sharrett, A. R., Blumenthal, R. S.
(2005). Enhanced Risk Assessment in Asymptomatic Individuals With Exercise Testing and Framingham Risk Scores. Circulation
112: 1566-1572
[Abstract][Full Text]
Lauer, M., Froelicher, E. S., Williams, M., Kligfield, P.
(2005). Exercise Testing in Asymptomatic Adults: A Statement for Professionals From the American Heart Association Council on Clinical Cardiology, Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention. Circulation
112: 771-776
[Abstract][Full Text]
Tsai, S.-W., Lin, Y.-W., Wu, S.-K.
(2005). The effect of cardiac rehabilitation on recovery of heart rate over one minute after exercise in patients with coronary artery bypass graft surgery. Clin Rehabil
19: 843-849
[Abstract]
Brotman, D. J., Girod, J. P., Garcia, M. J., Patel, J. V., Gupta, M., Posch, A., Saunders, S., Lip, G. Y. H., Worley, S., Reddy, S.
(2005). Effects of Short-Term Glucocorticoids on Cardiovascular Biomarkers. J. Clin. Endocrinol. Metab.
90: 3202-3208
[Abstract][Full Text]
Jouven, X., Empana, J.-P., Schwartz, P. J., Desnos, M., Courbon, D., Ducimetiere, P.
(2005). Heart-Rate Profile during Exercise as a Predictor of Sudden Death. NEJM
352: 1951-1958
[Abstract][Full Text]
Smith, L. L., Kukielka, M., Billman, G. E.
(2005). Heart rate recovery after exercise: a predictor of ventricular fibrillation susceptibility after myocardial infarction. Am. J. Physiol. Heart Circ. Physiol.
288: H1763-H1769
[Abstract][Full Text]
Udelson, J. E., Selker, H. P.
(2005). Quantitative instruments for predicting risk ... and benefit. J Am Coll Cardiol
45: 730-732
[Full Text]
Tahara, N., Takaki, H., Taguchi, A., Suyama, K., Kurita, T., Shimizu, W., Miyazaki, S., Kawada, T., Sunagawa, K.
(2005). Pronounced HR variability after exercise in inferior ischemia: evidence that the cardioinhibitory vagal reflex is invoked by exercise-induced inferior ischemia. Am. J. Physiol. Heart Circ. Physiol.
288: H1179-H1185
[Abstract][Full Text]
Ricardo, D. R., de Almeida, M. B., Franklin, B. A., Araujo, C. G. S.
(2005). Initial and Final Exercise Heart Rate Transients: Influence of Gender, Aerobic Fitness, and Clinical Status. Chest
127: 318-327
[Abstract][Full Text]
Madias, J. E.
(2004). Blunted Decline in Systolic Blood Pressure After Exercise Predicts Future Acute Myocardial Infarction. Hypertension
44: 807-808
[Full Text]
Laukkanen, J. A., Kurl, S., Salonen, R., Lakka, T. A., Rauramaa, R., Salonen, J. T.
(2004). Systolic Blood Pressure During Recovery From Exercise and the Risk of Acute Myocardial Infarction in Middle-Aged Men. Hypertension
44: 820-825
[Abstract][Full Text]
Morise, A. P.
(2004). Heart Rate Recovery: Predictor of Risk Today and Target of Therapy Tomorrow?. Circulation
110: 2778-2780
[Full Text]
Chen, M. S., Blackstone, E. H., Pothier, C. E., Lauer, M. S.
(2004). Heart Rate Recovery and Impact of Myocardial Revascularization on Long-Term Mortality. Circulation
110: 2851-2857
[Abstract][Full Text]
Huang, Z.-G., Wang, X., Evans, C., Gold, A., Bouairi, E., Mendelowitz, D.
(2004). Prenatal Nicotine Exposure Alters the Types of Nicotinic Receptors That Facilitate Excitatory Inputs to Cardiac Vagal Neurons. J. Neurophysiol.
92: 2548-2554
[Abstract][Full Text]
Castro, R R T, Porphirio, G, Serra, S M, Nobrega, A C L
(2004). Cholinergic stimulation with pyridostigmine protects against exercise induced myocardial ischaemia. Heart
90: 1119-1123
[Abstract][Full Text]
Aktas, M. K., Ozduran, V., Pothier, C. E., Lang, R., Lauer, M. S.
(2004). Global Risk Scores and Exercise Testing for Predicting All-Cause Mortality in a Preventive Medicine Program. JAMA
292: 1462-1468
[Abstract][Full Text]
Dries, D. L., Verdino, R. J., Kowal, R. C.
(2004). Postexercise severe ventricular ectopy in heart failure patients: New marker for aggregate risk. J Am Coll Cardiol
44: 827-828
[Full Text]
Nasir, K., Redberg, R. F., Budoff, M. J., Hui, E., Post, W. S., Blumenthal, R. S.
(2004). Utility of Stress Testing and Coronary Calcification Measurement for Detection of Coronary Artery Disease in Women. Arch Intern Med
164: 1610-1620
[Abstract][Full Text]
Danson, E. J. F., Mankia, K. S., Golding, S., Dawson, T., Everatt, L., Cai, S., Channon, K. M., Paterson, D. J.
(2004). Impaired regulation of neuronal nitric oxide synthase and heart rate during exercise in mice lacking one nNOS allele. J. Physiol.
558: 963-974
[Abstract][Full Text]
Lauer, M. S.
(2004). Chronotropic incompetence: Ready for prime time. J Am Coll Cardiol
44: 431-432
[Full Text]
Erikssen, G., Bodegard, J., Bjornholt, J. V., Liestol, K., Thelle, D. S., Erikssen, J.
(2004). Exercise testing of healthy men in a new perspective: from diagnosis to prognosis. Eur Heart J
25: 978-986
[Abstract][Full Text]
De Angelis, K., Wichi, R. B., Jesus, W. R. A., Moreira, E. D., Morris, M., Krieger, E. M., Irigoyen, M. C.
(2004). Exercise training changes autonomic cardiovascular balance in mice. J. Appl. Physiol.
96: 2174-2178
[Abstract][Full Text]
Raymond, L. W.
(2004). Vagal Pas de Deux: Heart-Lung Interplay in Postexercise Heart Rate Recovery. Chest
125: 1186-1190
[Full Text]
Seshadri, N., Gildea, T. R., McCarthy, K., Pothier, C., Kavuru, M. S., Lauer, M. S.
(2004). Association of an Abnormal Exercise Heart Rate Recovery With Pulmonary Function Abnormalities. Chest
125: 1286-1291
[Abstract][Full Text]
Lai, S., Kaykha, A., Yamazaki, T., Goldstein, M., Spin, J. M., Myers, J., Froelicher, V. F.
(2004). Treadmill scores in elderly men. J Am Coll Cardiol
43: 606-615
[Abstract][Full Text]
Recordati, G., Bellini, T. G.
(2004). A definition of internal constancy and homeostasis in the context of non-equilibrium thermodynamics. Exp Physiol
89: 27-38
[Abstract][Full Text]
Yawn, B. P., Ammar, K. A., Thomas, R., Wollan, P. C.
(2003). Test-Retest Reproducibility of Heart Rate Recovery After Treadmill Exercise. Ann Fam Med
1: 236-241
[Abstract][Full Text]
Carnethon, M. R., Jacobs, D. R. Jr., Sidney, S., Liu, K.
(2003). Influence of Autonomic Nervous System Dysfunction on the Development of Type 2 Diabetes: The CARDIA study. Diabetes Care
26: 3035-3041
[Abstract][Full Text]
Gulati, M., Pandey, D. K., Arnsdorf, M. F., Lauderdale, D. S., Thisted, R. A., Wicklund, R. H., Al-Hani, A. J., Black, H. R.
(2003). Exercise Capacity and the Risk of Death in Women: The St James Women Take Heart Project. Circulation
108: 1554-1559
[Abstract][Full Text]
Mora, S., Redberg, R. F., Cui, Y., Whiteman, M. K., Flaws, J. A., Sharrett, A. R., Blumenthal, R. S.
(2003). Ability of Exercise Testing to Predict Cardiovascular and All-Cause Death in Asymptomatic Women: A 20-Year Follow-up of the Lipid Research Clinics Prevalence Study. JAMA
290: 1600-1607
[Abstract][Full Text]
Vivekananthan, D. P., Blackstone, E. H., Pothier, C. E., Lauer, M. S.
(2003). Heart rate recovery after exercise is apredictor of mortality, independent of the angiographic severity of coronary disease. J Am Coll Cardiol
42: 831-838
[Abstract][Full Text]
Chaitman, B. R.
(2003). Abnormal heart rateresponses to exercise predict increased long-term mortality regardless of coronary disease extent: The question is why?. J Am Coll Cardiol
42: 839-841
[Full Text]
Liao, L., Mark, D. B.
(2003). Clinical prediction models: are we building better mousetraps?. J Am Coll Cardiol
42: 851-853
[Full Text]
Androne, A S, Hryniewicz, K, Goldsmith, R, Arwady, A, Katz, S D
(2003). Acetylcholinesterase inhibition with pyridostigmine improves heart rate recovery after maximal exercise in patients with chronic heart failure. Heart
89: 854-858
[Abstract][Full Text]
Previous
