| Early heart rate recovery after exercise predicts mortality in patients with chronic heart failure. | |
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MedLine Citation:
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PMID: 16371237 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Patients with chronic heart failure (CHF) have multiple abnormalities of autonomic regulation that have been associated to their high mortality rate. Heart rate recovery immediately after exercise is an index of parasympathetic activity, but its prognostic role in CHF patients has not been determined yet. METHODS: Ninety-two stable CHF patients (83M/9F, mean age: 51+/-12 years) performed an incremental symptom-limited cardiopulmonary exercise testing. Measurements included peak O2 uptake (VO2p), ventilatory response to exercise (VE/VCO2 slope), the first-degree slope of VO2 for the 1st minute of recovery (VO2/t-slope), heart rate recovery [(HRR1, bpm): HR difference from peak to 1 min after exercise] and chronotropic response to exercise [%chronotropic reserve (CR, %)=(peak HR-resting HR/220-age-resting HR)x100]. Left ventricular ejection fraction (LVEF, %) was also measured by radionuclide ventriculography. RESULTS: Fatal events occurred in 24 patients (26%) during 21+/-6 months of follow-up. HRR1 was lower in non-survivors (11.4+/-6.4 vs. 20.4+/-8.1; p<0.001). All cause-mortality rate was 65% in patients with HRR1<or=12 bpm versus 11% in patients with HRR1>12 bpm (log-rank: 32.6; p<0.001). By multivariate survival analysis, HRR1 resulted as an independent predictor of mortality (chi2=19.2; odds ratio: 0.87; p<0.001) after adjustment for LVEF, VO2p, VE/VCO2 slope, CR and VO2/t-slope. In a subgroup of patients with intermediate exercise capacity (VO2p: 10-18, ml/kg/min), HRR1 was a strong predictor of mortality (chi2: 14.3; odds ratio: 0.8; p<0.001). CONCLUSIONS: Early heart rate recovery is an independent prognostic risk indicator in CHF patients and could be used in CHF risk stratification. |
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Authors:
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Serafim Nanas; Maria Anastasiou-Nana; Stavros Dimopoulos; Dimitrios Sakellariou; George Alexopoulos; Smaragdo Kapsimalakou; Panagiotis Papazoglou; Elias Tsolakis; Ourania Papazachou; Charis Roussos; John Nanas |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2005-12-20 |
Journal Detail:
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Title: International journal of cardiology Volume: 110 ISSN: 0167-5273 ISO Abbreviation: Int. J. Cardiol. Publication Date: 2006 Jun |
Date Detail:
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Created Date: 2006-06-12 Completed Date: 2006-11-13 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8200291 Medline TA: Int J Cardiol Country: Ireland |
Other Details:
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Languages: eng Pagination: 393-400 Citation Subset: IM |
Affiliation:
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Pulmonary and Critical Care Medicine Department, Cardiopulmonary Exercise Testing and Rehabilitation Laboratory, Evgenidio Hospital, National and Kapodestrian University of Athens, 20, Papadiamantopoulou str, Athens, 11528, Greece. snanas@cc.uoa.gr |
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| MeSH Terms | |
Descriptor/Qualifier:
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Chronic Disease Exercise / physiology* Female Heart Failure / diagnosis*, mortality* Heart Rate / physiology* Humans Lung / physiology Male Middle Aged Prognosis ROC Curve Risk Factors Survival Rate Time Factors |
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