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Warm-up phenomenon and cardiac autonomic control in patients with coronary artery disease

Petri Tuomainen1, Juha Hartikainen, Esko Vanninen

  • 1Department of Internal Medicine, Kuopio University Hospital, P.O. Box 1777, 70211 Kuopio, Finland. Petri.Tuomainen@kuh.fi

Life Sciences
|March 1, 2005
PubMed

Insights

Patients with coronary artery disease (CAD) showing the warm-up phenomenon have better cardiac autonomic control. This adaptation to exercise-induced ischemia correlates with improved heart rate variability (HRV) measures.

Area of Science:

  • Cardiology
  • Autonomic Nervous System Function
  • Exercise Physiology

Background:

  • Decreased heart rate variability (HRV) and heart rate turbulence (HRT) predict mortality post-acute myocardial infarction (AMI).
  • The relationship between the warm-up phenomenon and cardiac autonomic control in stable coronary artery disease (CAD) remains unstudied.

Purpose of the Study:

  • To investigate HRV responses to repeated exercise-induced ischemia.
  • To compare global HRV and HRT in CAD patients with and without ischemia adaptation (warm-up phenomenon).

Main Methods:

  • Fifty male CAD patients underwent two successive exercise tests with ambulatory ECG recordings.
  • HRV analyzed using time and frequency domain measures; HRT assessed in patients with ventricular premature complexes (VPCs).
  • Patients categorized into warm-up positive (adaptation) and warm-up negative groups.

Main Results:

  • The warm-up positive group exhibited significantly higher total power, ULF, VLF power, and pNN50 (P<0.05).
  • Baseline total power, VLF power, and pNN50 were higher in the warm-up positive group.
  • Total power, ULF/VLF power, and SDNN positively correlated with reduced ischemic burden during recovery (P≤0.001).
  • No significant differences in HRT were observed between groups.

Conclusions:

  • CAD patients with the warm-up phenomenon demonstrate superior cardiac autonomic control.
  • This improved autonomic control correlates with the degree of ischemia adaptation during exercise.
  • Further prospective studies are needed to determine the prognostic significance of these findings.

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