Integrated heart rate and oxygen uptake recovery phenotypes reveal heterogeneous recovery patterns in coronary artery disease


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Ata B. N., Unal B., Celik M., İNCE B., Cinar E.

Frontiers in Medicine, cilt.13, 2026 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 13
  • Basım Tarihi: 2026
  • Doi Numarası: 10.3389/fmed.2026.1894821
  • Dergi Adı: Frontiers in Medicine
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, Directory of Open Access Journals, Health Research Premium Collection (ProQuest)
  • Anahtar Kelimeler: cardiac rehabilitation, cardiopulmonary exercise testing, coronary artery disease, heart rate recovery, oxygen consumption, ventilatory efficiency
  • Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Introduction – Heart rate recovery (HRR) and oxygen uptake (VO₂) recovery provide complementary information regarding autonomic and metabolic recovery following exercise; however, their integrated assessment remains insufficiently explored in patients with coronary artery disease (CAD). Methods – This retrospective observational study included 200 patients with stable CAD who underwent symptom-limited cardiopulmonary exercise testing (CPET). HRR at 1 min (HRR1), ΔVO₂ values, and VO₂ recovery indices were analyzed, and patients were classified according to combined HRR and VO₂ recovery patterns using a 2 × 2 recovery framework. Results – HRR1 was significantly correlated with ΔVO₂1 (r = 0.519, p < 0.001) and ΔVO₂2 (r = 0.510, p < 0.001), as well as VO₂ recovery indices at 1 and 2 min (r = 0.496 and 0.531, respectively; both p < 0.001). Distinct concordant and discordant recovery phenotypes were identified, indicating heterogeneity in post-exercise recovery dynamics. Significant differences were observed across recovery groups, including significantly lower VO₂ recovery in the Good HRR–Poor VO₂ phenotype compared with the Poor HRR–Good VO₂ phenotype (p = 0.027). Discussion – Post-exercise recovery in CAD appears to be a multidimensional physiological process that cannot be fully characterized by a single parameter. Integrated assessment of HRR and VO₂ recovery may provide a framework for recovery characterization before cardiac rehabilitation, and prospective studies are needed to validate the clinical applicability of this approach.