Preoperative exercise heart rate recovery predicts intraoperative hypotension in patients undergoing noncardiac surgery

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dc.contributor.authorKose, Emine Arzu
dc.contributor.authorKabul, Hasan Kutsi
dc.contributor.authorYildirim, Vedat
dc.contributor.authorTulmac, Murat
dc.date.accessioned2020-06-25T17:52:41Z
dc.date.available2020-06-25T17:52:41Z
dc.date.issued2012
dc.departmentKırıkkale Üniversitesi
dc.description.abstractStudy Objective: To assess the predictive role of heart rate (HR) recovery in the detection of intraoperative hypotension in patients undergoing noncardiac surgery. Design: Prospective, observational study. Setting: Department of cardiology and operating rooms of university hospitals. Patients: 160 ASA physical status 1 and 2 patients scheduled for elective noncardiac surgery. Measurements: All patients underwent exercise stress testing. Maximum HRs and metabolic equivalent levels were recorded. Heart rate recovery at the first, second, and third minutes were calculated by subtracting HRs one, two, and three minutes into the recovery period from the maximal HR at peak exercise. A decrease in mean arterial pressure (MAP) of greater than 30% was defined as intraoperative hypotension and recorded. Patients were classified to two groups according to whether they had intraoperative hypotension. Main Results: Hypotensive episode was observed in 31 patients (19.7%) during the operation. The presence of diabetes mellitus was higher in patients with intraoperative hypotension (22.6% vs 7.1%, P = 0.019). Mean HR recovery at the first, second, and third minutes was significantly lower in the intraoperative hypotension group (P = 0.001, P = 0.004, and P = 0.031, respectively). Heart rate recovery at the first, second, and third minutes was a good predictor of intraoperative hypotension, but only HR recovery at the first minute (OR 0.82, 95% CI 0.73 to 0.92, P = 0.001) and HR recovery at the second minute (OR, 0.90; 95% CI, 0.82 to 0.98; P = 0.019) were independent predictors of intraoperative hypotension. A higher negative correlation was noted between the degree of MAP reduction and HR recovery at the first minute (r = -0.797, P = 0.001). Conclusions: Abnormal preoperative exercise HR recovery predicts intraoperative hypotension in patients undergoing noncardiac surgery. Given the importance of intraoperative hypotension, preoperative use of exercise testing might be considered. (c) 2012 Elsevier Inc. All rights reserved.en_US
dc.identifier.citationclosedAccessen_US
dc.identifier.doi10.1016/j.jclinane.2012.02.007
dc.identifier.endpage476en_US
dc.identifier.issn0952-8180
dc.identifier.issn1873-4529
dc.identifier.issue6en_US
dc.identifier.pmid22986319
dc.identifier.scopus2-s2.0-84866383757
dc.identifier.scopusqualityQ1
dc.identifier.startpage471en_US
dc.identifier.urihttps://doi.org/10.1016/j.jclinane.2012.02.007
dc.identifier.urihttps://hdl.handle.net/20.500.12587/5207
dc.identifier.volume24en_US
dc.identifier.wosWOS:000309432200007
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherElsevier Science Incen_US
dc.relation.ispartofJournal Of Clinical Anesthesia
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectExercise stress testingen_US
dc.subjectHeart rate recoveryen_US
dc.subjectIntraoperative hypotensionen_US
dc.titlePreoperative exercise heart rate recovery predicts intraoperative hypotension in patients undergoing noncardiac surgeryen_US
dc.typeArticle

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