{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T09:37:20Z","timestamp":1789983440104,"version":"4.0.1"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2012,8,13]],"date-time":"2012-08-13T00:00:00Z","timestamp":1344816000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetic Medicine"],"published-print":{"date-parts":[[2012,9]]},"abstract":"<jats:sec><jats:label\/><jats:p>Diabet. Med. 29, e312\u2013e320 (2012)<\/jats:p><\/jats:sec><jats:sec><jats:title>Abstract<\/jats:title><jats:p><jats:bold>Aims\u2002<\/jats:bold> Poor prognosis associated with blunted post\u2010exercise heart\u2010rate recovery may reflect autonomic dysfunction. This study sought the accuracy of post\u2010exercise heart\u2010rate recovery in the diagnosis of cardiac autonomic neuropathy, which represents a serious, but often unrecognized complication of Type\u20032 diabetes.<\/jats:p><jats:p><jats:bold>Methods\u2002<\/jats:bold> Clinical assessment of cardiac autonomic neuropathy and maximal treadmill exercise testing for heart\u2010rate recovery were performed in 135 patients with Type\u20032 diabetes and negative exercise echocardiograms. Cardiac autonomic neuropathy was defined by abnormalities in \u2265\u20032 of 7 autonomic function markers, including four cardiac reflex tests and three indices of short\u2010term (5\u2010min) heart\u2010rate variability. Heart\u2010rate recovery was defined at 1\u2010, 2\u2010 and 3\u2010min post\u2010exercise.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> Patients with cardiac autonomic neuropathy (<jats:italic>n<\/jats:italic>\u2003=\u200327; 20%) had lower heart\u2010rate recovery at 1\u2010, 2\u2010 and 3\u2010min post\u2010exercise (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030.01). Heart\u2010rate recovery demonstrated univariate associations with autonomic function markers (<jats:italic>r<\/jats:italic>\u2010values 0.20\u20130.46, <jats:italic>P<\/jats:italic>\u2003&lt;\u20030.05). Area under the receiver\u2010operating characteristic curve revealed good diagnostic performance of all heart\u2010rate recovery parameters (range 0.80\u20130.83, <jats:italic>P<\/jats:italic>\u2003&lt;\u20030.001). Optimal cut\u2010offs for heart\u2010rate recovery at 1\u2010, 2\u2010 and 3\u2010min post\u2010exercise were \u2264\u200328\u2003beats\/min (sensitivity 93%, specificity 69%), \u2264\u200350\u2003beats\/min (sensitivity 96%, specificity 63%) and \u2264\u200352\u2003beats\/min (sensitivity 70%, specificity 84%), respectively. These criteria predicted cardiac autonomic neuropathy independently of relevant clinical and exercise test information (adjusted odds ratios 7\u201328, <jats:italic>P<\/jats:italic>\u2003&lt;\u20030.05).<\/jats:p><jats:p><jats:bold>Conclusions\u2002<\/jats:bold> Post\u2010exercise heart\u2010rate recovery provides an accurate diagnostic test for cardiac autonomic neuropathy in Type\u20032 diabetes. The high sensitivity and modest specificity suggests heart\u2010rate recovery may be useful to screen for patients requiring clinical autonomic evaluation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1464-5491.2012.03719.x","type":"journal-article","created":{"date-parts":[[2012,6,4]],"date-time":"2012-06-04T18:45:31Z","timestamp":1338835531000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Diagnostic accuracy of heart\u2010rate recovery after exercise in the assessment of diabetic cardiac autonomic neuropathy"],"prefix":"10.1111","volume":"29","author":[{"given":"J. W.","family":"Sacre","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. L.","family":"Jellis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. S.","family":"Coombes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. 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