Abstract
To investigate the effect of diabetes mellitus on exercise heart rate and the role of impaired heart rate in excess mortality in diabetes. Patients without cardiovascular disease who underwent exercise testing from September 1, 1993, through December 31, 2010, were included. Mortality was determined from Mayo Clinic records and the Minnesota Death Index. Multivariate linear regression was used to compare heart rate responses in patients with vs without diabetes. Cox regression was used to determine the effect of abnormal heart rate recovery and abnormal chronotropic index on survival. A total of 21,396 patients (65.4% men) with a mean ± SD age of 51±11 years, including 1200 patients with diabetes (5.4%), were included. Patients with diabetes had a higher resting heart rate (81±14 vs 77±13 beats/min), lower peak heart rate (154±20 vs 165±19 beats/min), heart rate reserve (73±19 vs 88±19 beats/min), chronotropic index (0.86±0.22 vs 0.99±0.20), and heart rate recovery (15±8 vs 19±9 beats/min) vs patients without diabetes. There were 1362 deaths (6.4%) during a mean ± SD follow-up of 11.9±4.9 years. Adjusting for age, sex, and heart rate-lowering drug use, a chronotropic index less than 0.8 contributed significantly to risk in pati...Continue Reading
References
Apr 15, 1996·Circulation·M S LauerD Levy
Feb 18, 1999·JAMA : the Journal of the American Medical Association·M S LauerT H Marwick
Oct 28, 1999·The New England Journal of Medicine·C R ColeM S Lauer
Sep 16, 2000·JAMA : the Journal of the American Medical Association·E O NishimeM S Lauer
Oct 3, 2002·Circulation·Raymond J GibbonsUNKNOWN American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Ex
Dec 31, 2002·The American Journal of Cardiology·Niranjan SeshadriMichael S Lauer
Jul 2, 2003·Diabetes Care·Yiling J ChengSteven N Blair
Oct 28, 2003·Diabetes Care·Mercedes R CarnethonUNKNOWN CARDIA study
Dec 23, 2004·Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research·Prince J KannankerilJeffrey J Goldberger
May 13, 2005·The New England Journal of Medicine·Xavier JouvenPierre Ducimetière
Apr 7, 2007·Journal of Hypertension·Giuseppe ManciaPeter A Van Zwieten
Apr 21, 2007·European Journal of Cardiovascular Prevention and Rehabilitation : Official Journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology·Jonathan MyersVictor F Froelicher
Jan 19, 2008·Medicine and Science in Sports and Exercise·Karen M ChackoRaymond O Estacio
May 15, 2008·Diabetes Care·P Michael HoDavid J Magid
May 24, 2008·International Journal of Cardiology·Panagiotis GeorgouliasIoannis Fezoulidis
Jan 9, 2010·Diabetes Care·Jeffrey M CurtisUNKNOWN Look AHEAD Research Group
May 8, 2010·International Journal of Epidemiology·Xianglan ZhangWei Zheng
Mar 9, 2011·Circulation·Peter H Brubaker, Dalane W Kitzman
Jun 8, 2012·Diabetic Medicine : a Journal of the British Diabetic Association·J W SacreT H Marwick
Oct 24, 2012·Diabetic Medicine : a Journal of the British Diabetic Association·N M GranthamJ E Shaw
Aug 21, 2013·Diabetes Care·Jaana J KarjalainenMikko Paavo Tulppo
Mar 26, 2014·Journal of the American Heart Association·Abhijeet DhobleStephen L Kopecky
Oct 10, 2014·BMC Public Health·Yu-qian LiChong-jian Wang
Dec 3, 2014·Mayo Clinic Proceedings·Nóra SydóThomas G Allison
Dec 17, 2014·Frontiers in Endocrinology·Lucianne Righeti Monteiro TannusUNKNOWN Brazilian Type 1 Diabetes Study Group (BrazDiab1SG)
Dec 19, 2014·Frontiers in Endocrinology·Alberto VerrottiFrancesco Chiarelli
Feb 17, 2015·World Journal of Diabetes·Akif Serhat Balcıoğlu, Haldun Müderrisoğlu
Apr 4, 2015·Sports Medicine·Charly KeytsmanDominique Hansen
Citations
Mar 28, 2018·Journal of the American Heart Association·Nóra SydóThomas G Allison
Jan 16, 2019·European Journal of Preventive Cardiology·Hareld KempsMarco Guazzi
Mar 7, 2019·Blood Pressure·Vladan VukomanovicMarijana Tadic
Sep 7, 2019·PloS One·Rei-Yeuh ChangMalcolm Koo
Aug 2, 2019·Acta Diabetologica·Yijun YuYe Gu
Mar 3, 2021·Physiological Reports·Satoshi NashimotoAtsuhiro Tsubaki