Table 3

Previously Published Prognostic Studies Relating to the Decrease of HR After Exercise

StudyPopulationSample Size (% Women)Exclusion CriteriaFollow-Up y-mean)Test Protocol/Recovery StatusMinutes of Recovery/Cut-PointMortality (All-Cause)Sensitivity/Specificity for DeathOther Variables StudiedBeta-Blocker Status
Cole et al. (2)*Referral for exercise perfusion; 9% with known CAD2,428 (37)CABG, angiography, CHF/digoxin use, LBBB6Bruce, with 2 min cool-down; Sympton-limited1 min/beats/min213 (9%)(cut-point = 12 beats/min) 56%/77%; (cut-point = 8 beats/min) 33%/90%METS, male gender, age, perfusion defects on scintigraphy, chronotropic incompetenceUsed by 12% of study population; No association with abnormal test
Cole et al. (3)Participants in Lipid Research Clinics Prevalence study, asymptomatic5,234 (39)Beta-blockers, other cardiac meds, history of cardiovascular disease12Bruce, without cool-down; 85% age-predicted HR2 min/42 beats/min325 (6.2%), 35% felt to be cardiovascular follow-up 100%54%/69%No comparisonExcluded
Nishime et al. (1)Referral for ETT; 8% prior CABG, 75% screening asymptomatic, 9% prior MI9,454 (22)CHF, LBBB, digoxin, valvular heart disease5.2Bruce, with 2 min cool-down; symptom-limited1 min/12 beats/min312 (3%)49%/81%METS, maximal HR, Duke treadmill score; TM AP score and El-ST depression not prognosticHR recovery not predictive of death in beta-blocker group
Shetler (present study)Referral for Standard ETT; 42% with prior MI2,193 (all mean)CABG, angiography, LBBB, pacer6.8Ramp without cool-down; symptom limited2 min/22 beats/min413 (19%)35%/83%Age, METS, history of typical angina; Treadmill AP score and El-ST depression not prognosticUsed by 34% of the study population; HR recovery equally predictive

CABG = coronary artery bypass grafting; CAD = coronary artery disease; CHF = congestive heart failure; El = elevated; HR = heart rate; LBBB = left bundle branch block; METS = metabolic equivalents; MI = myocardial infarction.