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[Chronotropic incompetence predicts angiographic severity in patients with coronary artery disease]

Ying-jun Feng1, Han-dong Yang, Xin-wen Min

  • 1Department of Cardiology, Dongfeng Subsidiary Hospital of Yunyang Medical Colleges, Shiyan 442000, China. fyj184@hotmail.com

Zhonghua Xin Xue Guan Bing Za Zhi
|January 16, 2007
PubMed

Insights

Chronotropic incompetence, a reduced ability to increase heart rate, is linked to more severe coronary artery disease (CAD). This finding aids in predicting CAD severity and identifying high-risk patients.

Area of Science:

  • Cardiology
  • Exercise Physiology

Background:

  • Coronary artery disease (CAD) affects millions globally, necessitating accurate diagnostic and prognostic tools.
  • Chronotropic incompetence (CI) is a potential indicator of cardiovascular health, but its relationship with CAD severity requires further elucidation.

Purpose of the Study:

  • To investigate the relationship between chronotropic incompetence and the angiographic severity of coronary artery disease.
  • To determine if CI can predict the extent of coronary artery narrowing.

Main Methods:

  • 130 patients underwent coronary angiography, with disease severity quantified by Duke and Gensini scores.
  • Patients were categorized into non-CAD, one-, two-, or three-vessel CAD groups.
  • Heart rate reserve (HRR) and percent maximal age-predicted heart rate achieved (rHR) were measured via exercise treadmill tests prior to angiography.

Main Results:

  • Lower rHR and HRR were observed in patients with two- and three-vessel CAD compared to non-CAD and one-vessel CAD groups (P<0.05).
  • Both rHR and HRR showed significant negative correlations with Duke and Gensini scores (P<0.01).
  • A 75% CAD incidence was noted in patients with positive rHR or HRR but without ST depression during exercise.

Conclusions:

  • Chronotropic incompetence is negatively associated with angiographic coronary severity, serving as a predictor of CAD extent.
  • Positive rHR or HRR without ST depression during exercise indicates a high likelihood of significant CAD.
Abstract

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