Helder Quirino Fernandes MD, Presenter: Nothing to Disclose

Elisabete Martins, Abstract Co-Author: Nothing to Disclose

Patricia Oliveira, Abstract Co-Author: Nothing to Disclose

José Pedro Henriques Patrício MD, Abstract Co-Author: Nothing to Disclose

Ana Cristina Oliveira, Abstract Co-Author: Nothing to Disclose

Jorge Pereira MD, Abstract Co-Author: Nothing to Disclose

Maria Teresa Faria, Abstract Co-Author: Nothing to Disclose

João Carlos Silva MD, Abstract Co-Author: Nothing to Disclose

00030490-DMT et al, Abstract Co-Author: Nothing to Disclose

Recent studies have shown that resting heart rate is an important prognostic factor for sudden cardiac death and heart failure among patients with known cardiac disease. The aim of our study was to evaluate if resting heart rate could also be a risk factor for the diagnosis of coronary artery disease (CAD).  

We conducted a retrospective study selecting patients submitted to adenosine MPS (Myocardial Perfusion Scintigraphy) for thoracic pain and/or pre-operative cardiac risk assessment, without proven CAD diagnosis, who had had a CA (Coronary Angiography) within a six month interval. For each patient we evaluated cardiovascular signs and symptoms, cardiovascular drugs use, ECG, including resting and maximal heart rate, the presence of Diabetes mellitus and of CAD on CA. Each MPS was analysed using QGS/QPS® software to determine the Summed Stress Score (SSS), Summed Rest Score (SRS), Summed Difference Score (SDS), defect extent and ejection fraction in the left ventricle.

A total of seventy (70) patients were evaluated, 36 female (51%), mean age of 65±11 years, 21% were diabetic and 20% had left bundle branch blockage. On MPS 67% (47) patients had no or mild defects and 33% (23) patients had moderate or severe defects. SSS was 7.3±5.0, SRS 2.5±3.6, SDS 5.6±2.2, stress defect extent 9.7±7.4%, rest defect extent 5.5±5.8% and the ejection fraction was 50±13%. On CA 33% had significant disease (coronary stenosis >50%). Resting mean heart rate was 75±13 beats per minute and maximal heart rate was 88±16 beats per minute. Basal heart rate was positively correlated with SSS (p=0.013) and defect stress extent (p=0.007), and negatively correlated to the ejection fraction (p=0.004).  

In our study patients showed a positive correlation between their resting heart rate and the presence of MPS abnormalities.

If this finding is confirmed in larger series, heart rate should be taken into account in a CAD risk profile.

Fernandes, H, Martins, E, Oliveira, P, Patrício, J, Oliveira, A, Pereira, J, Faria, M, Silva, J, et al, 0, Is Heart Rate a Risk Factor for Coronary Disease?.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8008180.html