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J Am Coll Cardiol, 2004; 43:925, doi:10.1016/j.jacc.2003.12.019
© 2004 by the American College of Cardiology Foundation
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LETTER TO THE EDITOR

Heart rate recovery after exercise is not demonstrated as a predictor of mortality: maybe after treadmill-exercise

Nicola Gaibazzi, MD

Ospedale Civile di Desenzano del Garda, Department of Cardiology, Via Bardolino 23-25015, Desenzano del Garda, BS, Italy

nicola.gaibazzi{at}inwind.it

Regarding the elegant and innovative study by Vivekananthan et al., entitled "Heart Rate Recovery After Exercise Is a Predictor of Mortality, Independent of the Angiographic Severity of Coronary Disease" recently published in JACC (1), I must object that the title of such a good report is substantially wrong. In fact, the word "exercise" should have been more precisely substituted with the words "treadmill-exercise." This is definitely not a trivial correction, for no study has ever demonstrated that heart rate recovery (HRR) after any type of exercise other than treadmill has any relation with mortality. My group has completed a study of 1-min HRR after cycloergometer-exercise test as a predictor of mortality in a cohort of 1,420 real-life exercise-test candidates; we found substantial differences compared to the treadmill-derived parameter. I can surely state that no evidence has ever been published in the peer-reviewed medical literature linking HRR and mortality using any exercise modality other than treadmill-exercise. This should be emphasized, as many clinicians could be tempted to apply these results to other clinical exercise settings.


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  1. Vivekananthan DP, Blackstone EH, Pothier CE, Lauer MS. Heart rate recovery after exercise is a predictor of mortality, independent of the angiographic severity of coronary disease. J Am Coll Cardiol. 2003;42:831–838[Abstract/Free Full Text]




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