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학술저널
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한국심초음파학회 Journal of Cardiovascular Imaging Journal of Cardiovascular Imaging 제27권 제3호
발행연도
2019.1
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214 - 223 (10page)

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BACKGROUND: This study evaluated whether blunted autonomic activity as measured by heart rate recovery (HRR) was associated with increased arterial stiffness, especially increased exercise-induced arterial stiffness, in normotensive patients without overt atherosclerosis. METHODS: One hundred fifty-four normotensive patients without overt atherosclerosis who had undergone a treadmill exercise test were consecutively enrolled. HRR was measured at one minute after exercise. Brachial-ankle pulse wave velocity (baPWV) at rest was measured, and carotid arterial stiffness indices at rest (CSI at rest) and after exercise (CSI after exercise) were assessed. RESULTS: Patients with slow HRR were older and tended to be male, and they had diabetes, higher resting and peak systolic blood pressures, higher resting heart rate, lower peak heart rate, lower metabolic equivalents, increased baPWV, and increased CSIs at rest and after exercise. HRR was inversely associated with baPWV and CSI after exercise when established cardiovascular risk factors were adjusted as confounding factors, and HRR was associated with CSI after exercise when resting systolic blood pressure and metabolic equivalent of tasks on cardiovascular risk factors were added as confounding factors. CONCLUSIONS: Sympathovagal imbalance demonstrated by slow HRR was associated with increased arterial stiffness and, above all, was closely associated with exercise-induced arterial stiffness in normotensive patients without overt atherosclerosis. This phenomenon might have been observed because blunt carotid arterial vasomotion following exercise results from autonomic dysfunction as well as vascular endothelial dysfunction.

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참고문헌 (38)

참고문헌 신청
Imai K / 1994 / Vagally mediated heart rate recovery after exercise is accelerated in athletes but blunted in patients with chronic heart failure / J Am Coll Cardiol 24:1529~1535 google schola Kleiger RE / 1987 / Decreased heart rate variability and its association with increased mortality after acute myocardial infarction / Am J Cardiol 59:256~262 google schola Beltran A / 2001 / Arterial compliance abnormalities in isolated systolic hypertension / Am J Hypertens 14:1007~1011 google schola Gedikli O / 2010 / Effects of prehypertension on arterial stiffness and wave reflections / Clin Exp Hypertens 32:84~89 google schola Laurent S / 2006 / Expert consensus document on arterial stiffness : methodological issues and clinical applications / Eur Heart J 27:2588~2605 google schola

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