Mitral annular calcification is associated with postexercise heart rate recovery

Mitral annular calcification (MAC) is a chronic, degenerative disease characterized by accumulation of calcium and lipid in the fibrous ring of the mitral valve. Heart rate recovery index (HRR) calculated after treadmill exercise test is a predictor of autonomic dysfunction and cardiovascular mortality. The aim of this study was to investigate the relationship between MAC and HRR parameters. 64 patients with MAC (mean age 54.9±5.8, 40 males) and 44 healthy controls (mean age 55.1±6.5, 28 males) were included in the study. All subjects in the MAC group and control group underwent basal 12-lead electrocardiography, echocardiography, and treadmill exercise test at a target rate determined by age. HRR indices were calculated from the maximal heart rate by subtracting the heart rate at the 1st, 2nd and 3rd minutes of the recovery period. Baseline demographic and laboratory data were similar in both groups. Compared with healthy controls, individuals with MAC had decreased HRR at 1 (HRR1), 2 (HRR2), and 3 (HRR3) minutes [16.9 ± 4.5 vs. 19.2 ± 3.9, p = 0.009; 33.9 ± 4.6. 36.2 ± 5.1, p = 0.019; 49.6 ± 7.1. 52.4 ± 6.1, p = 0.035; respectively]. These results show that heart rate recovery after exercise is impaired in individuals with MAC. Given the independent prognostic value of HRR, these findings can be evaluated in terms of symptomology of autonomic dysfunction in people with MAC. Because HRR is a simple and inexpensive method, it may be useful in identifying high-risk patients, especially in individuals with MAC

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1. Movahed MR, Saito Y, Ahmadi-Kashani M, et al. Mitral annulus calcification is associated with valvular and cardiac structural abnormalities. Cardiovasc Ultrasound. 2007;5:14.

2. Massera D, Kizer JR, Dweck MR. Mechanisms of mitral annular calcification. Trends Cardiovasc Med. 2019.

3. Aronow WS, Koenigsberg M, Kronzon I, et al. Association of mitral anular calcium with new thromboembolic stroke and cardiac events at 39-month follow-up in elderly patients. Am J Cardiol. 1990;65:1511-2.

4. Sannino A, Losi MA, Giugliano G, et al. Aortic and mitral calcification is marker of significant carotid and limb atherosclerosis in patients with first acute coronary syndrome. Echocardiography. 2015;32:1771-7.

5. Fox CS, Vasan RS, Parise H, et al. Mitral annular calcification predicts cardiovascular morbidity and mortality: the Framingham Heart Study. Circulation. 2003;107:1492-1496.

6. Desai MY, De la Pena-Almaguer E, Mannting F. Abnormal heart rate recovery after exercise as a reflection of an abnormal chronotropic response. Am J Cardiol. 2001;87:1164-9.

7. 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.

8. Chacko KM, Bauer TA, Dale RA, et al. Heart rate recovery predicts mortality and cardiovascular events in patients with type 2 diabetes. Med Sci Sports Exerc. 2008;40:288-95.

9. Van de Vegte YJ, van der Harst P, Verweij N. Heart rate recovery 10 seconds after cessation of exercise predicts death. J Am Heart Assoc. 2018;7:e008341.

10. 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.

11. Kohsaka S, Jin Z, Rundek T, et al. Impact of mitral annular calcification on cardiovascular events in a multiethnic community: the Northern Manhattan Study. JACC Cardiovasc Imaging. 2008;1:617-23.

12. Boon A, Cheriex E, Lodder J, et al. Cardiac valve calcification: characteristics of patients with calcification of the mitral annulus or aortic valve. Heart. 1997;78:472-4.

13. Spies C, Otte C, Kanaya A, et al. Association of metabolic syndrome with exercise capacity and heart rate recovery in patients with coronary heart disease in the heart and soul study. Am J Cardiol. 22005;95:1175-9.

14. van de Vegte YJ, Tegegne BS, Verweij N, et al. Genetics and the heart rate response to exercise. Cellular and molecular life sciences :CMLS. 2019;76:2391-409.

15. Perini R, Veicsteinas A. Heart rate variability and autonomic activity at rest and during exercise in various physiological conditions. Eur J Applied Physiol. 2003;90:317-25.

16. Lahiri MK, Kannankeril PJ, Goldberger JJ. Assessment of autonomic function in cardiovascular disease: physiological basis and prognostic implications. J Am College Cardiol. 2008;51:1725-33.

17. Chaitman BR. Abnormal heart rate responses to exercise predict increased long-term mortality regardless of coronary disease extent: the question is why? J Am Coll Cardiol. 2003;42:839-41.
Medicine Science-Cover
  • ISSN: 2147-0634
  • Yayın Aralığı: 4
  • Başlangıç: 2012
  • Yayıncı: Effect Publishing Agency ( EPA )
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