Study On The Diagnostic Value Of Delayed Heart Rate Recovery During Treadmill Exercise Test In Patients With Coronary Heart Disease

Objective:Treadmill exercise test was used to analyze the recovery of heart rate in patients with coronary heart disease and to explore the recovery of heart rate and its clinical application value.Method:One hundred and nine patients with clinically suspected coronary heart disease were enrolled and underwent a treadmill exercise test(TET)and coronary angiography(CAG)successively.According to the heart rate recovery value(HR1)at 1 min after the cessation of the treadmill exercise test,they were divided into a normal heart rate recovery group(n=73)and a delayed rate recovery group(n=36)after the exercise test.The results of coronary angiography,relevant clinical data and exercise parameters of the two groups were compared and analyzed.Results:(1)Delayed heart rate recovery was associated with diabetes,hyperlipidemia,hyperuricemia,smoking,age,and anxiety(P<0.05),and there were no statistically significant differences in other related clinical factors.(2)Resting heart rate,peak heart rate,exercise duration,exercise load(METs),and heart rate recovery(HR1,HR2)were lower in the coronary heart disease group than in the non-coronary heart disease group,age and resting systolic blood pressure were higher in the coronary heart disease group than in the non-coronary heart disease group,and the differences were statistically significant(P<0.05);there was no significant difference in resting diastolic blood pressure,peak systolic blood pressure,and peak diastolic blood pressure between the two groups.Heart rate values at each time point after exercise in the coronary heart disease group and the non-coronary heart disease group showed:the time point effect could significantly affect the change in heart rate,F(6,102)=152.076,P=.000<0.05;second,whether the patient had coronary heart disease could also significantly affect the patient's heart rate,F(1,107)=19.513,P=.000<0.05;further,there was no interaction effect between time point and group,F(6,102)=0.611,P=0.721>0.05.Heart rate significantly changed from 1 to 4 minutes in the coronary heart disease group,but not from 4 to 7 minutes;heart rate significantly changed from 1 to 5 minutes in the non-coronary heart disease group,but not from 5 to 7 minutes.(3)The Gokmen score,a quantitative indicator of the degree of coronary artery disease,was higher in the delayed heart rate recovery group than in the normal heart rate group(3.4±3.4 vs 2.1 ± 2.8,P<0.05),and the difference was statistically significant.(4)The sensitivity of ? HR1 combined with ST segment depression is higher than that of single use,the specificity is lower than that of single use,and the missed diagnosis rate is lower than that of single use.ROC curve was used to analyze the sensitivity and specificity of the three methods for the diagnosis of coronary heart disease.The three methods were all effective in the diagnosis of coronary heart disease,and there was no difference between the comprehensive sensitivity and the specificity of the three methods.Conclusion:Delayed heart rate recovery is associated with diabetes,hyperlipidemia,hyperuricemia,smoking,age,and anxiety disorders.Heart rate recovery(HR1,HR2)was lower in the coronary heart disease group than in the non-coronary heart disease group.The time point effect can significantly affect the change of heart rate recovery,and whether the patient has coronary heart disease can also significantly affect the patient's heart rate recovery.Delayed heart rate recovery can serve as an indicator to effectively determine the severity of coronary artery stenosis.The sensitivity of ? HR1 combined with ST segment depression is higher than that of single use,the specificity is lower than that of single use,and the missed diagnosis rate is lower than that of single use.ROC curve was used to analyze the sensitivity and specificity of the three methods for the diagnosis of coronary heart disease.The three methods were all effective in the diagnosis of coronary heart disease,and there was no difference between the comprehensive sensitivity and the specificity of the three methods.