Document Detail

Association of an abnormal exercise heart rate recovery with pulmonary function abnormalities.
MedLine Citation:
PMID:  15078736     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Heart rate recovery (HRR) after exercise correlates with decreased vagal tone and mortality. Patients with COPD may have altered autonomic tone. We sought to determine the association of HRR with spirometry measures of pulmonary function. METHODS: We analyzed 627 patients (mean [+/- SD] age, 58 +/- 12 years; 65% men; mean FEV(1), 2.6 +/- 0.9 L, 80 +/- 20% predicted; patients receiving inhaled beta(2) agonist therapy, 10%; patients receiving inhaled anticholinergic therapy, 3%; patients receiving inhaled steroids, 5%; patients receiving oral prednisone, 4%) who had undergone maximal exercise testing and had undergone pulmonary function tests < 1 year apart. Patients with heart failure, pacemakers, and atrial fibrillation were excluded. Abnormal HRR was defined as a fall in heart rate during the first minute after exercise of <or= 12 beats/min (<or= 18 beats/min with stress echocardiography). Patients were divided into quartiles based on FEV(1) percent predicted. RESULTS: An abnormal HRR was seen in 229 patients (36%). The mean FEV(1) values broken into quartiles 1 to 4 were 54 +/- 11% predicted, 74 +/- 3% predicted, 87 +/- 4% predicted, and 106 +/- 10% predicted. In smokers and nonsmokers, a worsening FEV(1) percent predicted was associated with an abnormal HRR. In a multivariable model accounting for confounding factors including medications and functional capacity, the predictors of an abnormal HRR included FEV(1) percent predicted (adjusted odds ratio for 1 SD decrease, 1.32; 95% confidence interval, 1.07 to 1.65; p = 0.0004), impaired functional capacity, male gender, and age. CONCLUSIONS: Abnormalities found on spirometry are associated with abnormal HRR, which may reflect an altered autonomic tone associated with pulmonary dysfunction, either obstructive or restrictive in nature.
Niranjan Seshadri; Thomas R Gildea; Kevin McCarthy; Claire Pothier; Mani S Kavuru; Michael S Lauer
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Chest     Volume:  125     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-04-13     Completed Date:  2004-05-17     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1286-91     Citation Subset:  AIM; IM    
Department of Cardiology, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
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MeSH Terms
Autonomic Nervous System / physiopathology
Forced Expiratory Volume
Heart Rate / physiology*
Middle Aged
Pulmonary Disease, Chronic Obstructive / drug therapy,  physiopathology*
Grant Support
Comment In:
Chest. 2004 Apr;125(4):1186-90   [PMID:  15078721 ]

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