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One-minute heart rate recovery after cycloergometer exercise testing as a predictor of mortality in a large cohort of exercise test candidates: substantial differences with the treadmill-derived parameter.

BACKGROUND
Previous work showed a strong inverse association between 1-min heart rate recovery (HRR) after exercising on a treadmill and all-cause mortality. The aim of this study was to determine whether the results could be replicated in a wide population of real-world exercise ECG candidates in our center, using a standard bicycle exercise test.


METHODS
Between 1991 and 1997, 1420 consecutive patients underwent ECG exercise testing performed according to our standard cycloergometer protocol. Three pre-specified cut-point values of 1-min HRR, derived from previous studies in the medical literature, were tested to see whether they could identify a higher-risk group for all-cause mortality; furthermore, we tested the possible association between 1-min HRR as a continuous variable and mortality using logistic regression.


RESULTS
Both methods showed a lack of a statistically significant association between 1-min HRR and all-cause mortality. A weak trend toward an inverse association, although not statistically significant, could not be excluded.


CONCLUSIONS
We could not validate the clear-cut results from some previous studies performed using the treadmill exercise test. The results in our study may only "not exclude" a mild inverse association between 1-min HRR measured after cycloergometer exercise testing and all-cause mortality. The 1-min HRR measured after cycloergometer exercise testing was not clinically useful as a prognostic marker.