Emine ALTUNTAŞ, Bilal ÇUĞLAN, Şebnem KARACAY ÖZKAN

The assessment of heart rate recovery index in patientswith essential tremor

Aim: In this study, it was aimed to investigate whether heart rate recovery index(HRRI), which is marker of cardiovascular mortality, was affected in patients with essential tremor(ET).Materials and Method: The study was conducted as retrospective and it consisted of 30 patients with ET and 30 healthy controls which were similar in terms of age and gender. During admission blood pressure and heart rate, fasting blood tests, hemogram, transthoracic echocardiography and exercise stress test results were recorded.Results: The groups were similar in point of age, gender, smoking(p>0.05). Diastolic and systolic blood pressure of the groups were similar, whereas patients with ET had higher heart rate during admission. When exercise stress test results were assessed, 1st minute heart rate recovery, 2nd minute HRRI, 5th minute HRRI were lower in ET group and these differences were statistically significant(respectively p=0.017; 0.033; 0.019). However both groups were similiar with regards to 3rd minute HRRI(p=0.063)Conclusion: According to this study results it might be thought that cardiovascular and total mortality may be higher in ET patients than healthy controls due to lower HRRI. Furthermore, it can be speculated that this disease may have an autonomous component since HRRI might be marker of an abnormal autonomic nervous system response.

PDF

___

1. Okutucu S, Karakulak UN, Aytemir K, et al. Heart rate recovery: a pratical clinical indicator of abnormal cardiac autonomic function. Expert Rev Cardiovasc Ther 2011;9:1417-30.
2. Javorka M, Zila I, Balharek T, et al. Heart rate recovery after exercise: relations to heart rate variability and complexity. Braz J Med Biol Res 2002;35:991-1000.
3. Morshedi-Meibodi A, Larson MG, Levy D, et al. Heart rate recovery after treadmill exercise testing and risk of cardiovascular disease events (The Framingham Heart Study). Am J Cardiol 2002;90:848-52.
4. Sears CE, Choate JK, Paterson DJ. Inhibition of nitricoxide syntases lows heart rate recovery from cholinergic activation. J Apll Physiol 1998;85:1596- 603.
5. Higgins JP, Higgins JA. Electrocardiographic exercise stress testing: An up date beyond the ST segment. Int J Cardiol 2007;116:285-99.
6. Palatini P. Heart rate as an independent risk factor for cardiovascular disease: current evidence and basic mechanisms. Drugs 2007;67:3-13.
7. Kim SJ, Oh YS, Park HE, et al. Cardiovascular autonomic dysfunctions in elderly patients with essential tremor: comparison with healthy controls. Neurol Sci 2016;37:711-6.
8. Chandran V, Pal PK. Essential tremor: beyond the motor features. Parkinsonism Relat Disord 2012;18:407-13.
9. Teive HA. Essential tremor: phenotypes. Parkinsonism Relat Disord 2012;8:140-2.
10. Kim JS, Song IU, Shim YS, et al. Cognitive impairment in essential tremor without dementia. J Clin Neurol 2009;5:81-4
11. Habipoglu Y, Murat Alpua M, et al. Autonomic dysfunction in patients with essential tremor. Neurol Sci 2017;38:265-9.
12. Lee SM, Kim M, Lee HM, et al. Nonmotor syptoms in essential tremor: Comprasion with Parkinson’s disease and normal control. J Neurol Sci 2015;349:168-73.
13. Lauer M,Froelicher ES, Williams M, et al. Exercise testing in asymptomatic adults: a statement for professionals from the American Heart Association Council on Clinical Cardiology, Subcommittee on Exercise, Cardiac Rehabilitation and Prevention. Circulation 2005;112:771-6.
14. Sydo N, Sydo T, Carta KAG, et al. Prognostic performance of heart rate recovery on an exercixe test in a primary prevention population. J Am Heart Assoc. 2018;7: e008143.
15. Cole CR, Foody JM, Blackstone EH, et al. Heart rate recovery after submaximal exercise testing as a predictor of mortality in a cardiovascularly healthy cohort. Ann Intern Med 2000;132:552-5.
16. Aijaz B, Squires RW, Thomas RJ, et al. Predictive value of heart rate recovery and peak oxygen consumption for long-term mortality in patients with coronary heart disease. Am J Cardiol 2009;103:1641-6.
17. Maeder MT, Munzer T, Rickli H, et al. Association between heart rate recovery and severity of obstructive sleep apnea syndrome. Sleep Med 2008;9:753-61.
18. Yamada T, Yoshitama T, Makino K, et al. Heart rate recovery after exercise is a predictor of silent myocardial ischemia in patients with type 2 diabetes. Diabetes Care 2011;34:724-6.
19. Phan TT, Shivu GN, Abozguia K, et al. Impaired heart rate recovery and chronotropic incompetence in patients with heart failure with preserved ejection fraction. Circ Heart Fail 2010;3:29-34.
20. Oren H, Aytemir K. Heart rate recovery: clinical application and methods (Kalp Hızı Toparlanma İndeksi: Klinik Kullanım ve Yöntemler). Turk J Arrhythm Pacing Electrophysiol 2008;6:141-50.