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Aims: Chronotropic incompetence, an attenuated heart rate(HR) response to exer cise, is an independent predictor of cardiovascular mortality, but it is not kno wn whether chronotropic incompetence is related to carotid atherosclerosis. The association between chronotropic incompetence and carotid atherosclerosis in 856 7(age 47.6±8.8 years) healthy men was examined. Methods and results: Chronotrop ic incompetence was defined as the failure to achieve 85%of the age-predicted maximal HR(APMHR),< 80%HR reserve(HRR), and chronotropic response index(CRI). C arotid atherosclerosis was defined, using B-mode ultrasonography, as stenosis > 25%and/or intima-media thickness(IMT) of >1.2 mm. In multivariable adjusted lo gistic regression models, the subjects who achieved less than 85%of APMHR exhib ited an odds ratio(OR) of 1.72[95%confidence intervals(CI): 1.32-2.22] for car otid atherosclerosis. Subjects with< 80%of HRR were 1.45(95%CI: 1.14-1.84) ti mes more likely to have carotid atherosclerosis after multivariate adjustment. A lso, the OR of carotid atherosclerosis across quartiles of CRI(highest to lowest ) was 1.51(95%CI: 1.10-2.09) after multivariate adjustment. Conclusion: These results suggest that the chronotropic response to exercise is associated with ca rotid atherosclerosis, independent of the established risk factors in healthy me n, which could contribute to high incidence of cardiovascular diseases in subjec ts with chronotropic incompetence.
Aims: Chronotropic incompetence, an attenuated heart rate (HR) response to exer cise, is an independent predictor of cardiovascular mortality, but it is not kno wn whether chronotropic incompetence is related to carotid atherosclerosis. The association between chronotropic incompetence and carotid atherosclerosis in 856 Methods and results: Chronotrop ic incompetence was defined as the failure to 85% of the age-predicted maximal HR (APMHR), <80% HR reserve (HRR), and (age 47.6 ± 8.8 years) chronotropic response index (CRI). C arotid atherosclerosis was defined, using B-mode ultrasonography, as stenosis> 25% and / or intima-media thickness (IMT) of> 1.2 mm. In multivariable adjusted lo gistic regression models, the subjects who (less than 85% of APMHR exhibitors ited an odds ratio (OR) of 1.72 [95% confidence intervals (CI): 1.32-2.22] for carotid atherosclerosis. Subjects with <80% of HRR were 1.45 (95% CI: 1.14 -1.84) ti mes more likely to have carotid atherosclero A lso, the OR of carotid atherosclerosis across quartiles of CRI (highest to lowest) was 1.51 (95% CI: 1.10-2.09) after multivariate adjustment. Conclusion: These results suggest that the chronotropic response to exercise is associated with ca rotid atherosclerosis, independent of the established risk factors in healthy me n, which could contribute to high incidence of cardiovascular diseases in subjec ts with chronotropic incompetence.