Study On Change Of Heart Rate Recovery After Treadmill Exercise Test,and Its Influential Factors In Type2Diabetes

Part1Study on the association between heart rate recovery after treadmill exercise test and cardiac autonomic neuropathyObject To explore the association between heart rate recovery(HRR) after treadmill exercise test and cardiac autonomic neuropathy (DCAN). Method Ninety seven patients with type2diabetes were enrolled, HRR at the first, second, fifth minutes(HRR1,HRR2,HRR5) of treadmill exercise test was measured and Ewing test were applied. Those subjects were divided into diabetic group (normal autonomic nerve function, group0),mild DCAN group (group1), medium DCAN group(group2),and serious DCAN group(group3) according to the results of Ewing test, and differences of HRR were compared. The association between HRR and severity of DCAN was analysed by spearman correlation test. Result1) HRR1. HRR2. HRR5. HRR2%,HRR5%in group3were statistically lower than the group2,1.0; HRR2, HRR5in group2.1were statistically lower than group0separately,HRR1%was lower in group3than group1(P<0.05);2)11RR1was positively correlated with respiration difference,HRR2was positively correlated with Valsalva value and30s/15s. and HRR5was positively correlated with Valsalvaval (P<0.05).Conclusion There is a correlation between HRR after treadmill exercise and cardiac autonomic neuropathy, HRR may become a diagnostic method of cardiac autonomic neuropathy Part2Study on change of heart rate recovery after treadmill exercise test,and its influential factors in type2diabetesObject To explore the change of heart rate recovery after treadmill exercise test in type2diabetes,and its influential factors. Method Two hundred twenty three patients with type2diabetes and without coronary heart disease were enrolled, treadmill exercise test were applied and the subjects'data were collected. The differences of HRR(HRR1, HRR2, HRR5) in the negative group, suspective positive group and positive group of treadmill exercise were compared. All subjects were divided into four groups by diabetes mellitus, hypertension, dyslipidemia, overweight or obesity, compared HRR (HRR1, HRR2, HRR5) in different groups and the influential factors of HRR was analysed by stepwise multiple regression analysis. Result1) HRR1, HRR2, HRR5in positive group of treadmill exercise test were lower than the suspecti've positive and negative group. After adjusting for the confounding factors such as age and smoking, the difference were of significance (P<0.05).2) After adjusting confounding effects of WHR.BMI.WSR.UA.HDL HRR1. HRR2, HRR5in group4and group3were statistically lower than group1;HRR2.HRR5in group4were statistically lower than group Lgroup2and group3separately (P<0.05).3) Stepwise multiple regression analysis of the different composition clustering of HRR showed that:HRRI was negatively correlated with age and resting heart rate, while heart rate at peak exercise has positive correlation with IIRRI; HRR2and IIRR5were negatively correlated with smoking and resting heart rate, while HRR2and IIRR5were positively correlated with heart rate at peak exercise. Conclusion1) The differences of HRR were of signillcance in positive.suspective positive and negative group;2) the differences of HRR in the crowed of different composition of cardiovascular risks were of significance, the HRR became slower with the increasing of cardiovascular risks;3) The influential factors of HRR included age, smoking, resting heart rate, heart rate at peak exercise. Part3The effects of heart rate recovery after treadmill exercise test on predicting coronary artery disease in patients with type2diabetesObject To explore the effects of heart rate recovery after treadmill exercise test on predicting coronary artery disease(CAD) in patients with type2diabetes. Method The study enrolled fifteen subjects with type2diabetes. They underwent coronary artery computed tomography and coronary artery angiogram. HRR at first, second, fifth minutes(HRR1,HRR2,HRR5) in the CAD group and non-CAD group were compared. Result1) After adjusting confounding effects of TG, FA, the HRR1, HRR2, HRR5in CAD group were lower than the non-CAD group.(P<0.05) Conclusion1) HRR in CAD group were lower than the non-CAD group;2)Abnormal heart rate recovery after treadmill exercise should consider to be one of methods for screening for CAD in diabetes.