Document Detail

Heart rate recovery after six-minute walk test predicts pulmonary hypertension in patients with idiopathic pulmonary fibrosis.
MedLine Citation:
PMID:  20946337     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND OBJECTIVE: In patients with IPF, we sought to validate that abnormal heart rate recovery at 1 min (HRR1) after six-minute walk test (6MWT) predicts mortality and to explore the relationship between abnormal HRR1 and pulmonary hypertension (PH).
METHODS: We identified IPF patients who performed a 6MWT as part of their clinical evaluation between 2006 and 2009 and were followed to lung transplantation or death. Right heart catheterization (RHC) data were collated and analysed for the subgroup who had this procedure.
RESULTS: There were 160 subjects who qualified for the survival analysis, and those with an abnormal HRR1 had worse survival than subjects with normal HRR1 (log-rank P = 0.01). Eighty-two subjects had a right heart catheter (RHC); among them, abnormal HRR1 was associated with RHC-confirmed PH (χ(2) = 4.83, P = 0.03) and had a sensitivity, specificity, positive predictive value and negative predictive value of 52%, 74%, 41% and 82%, respectively, for PH. In bivariate and multivariable analyses, abnormal HRR1 appeared to be the strongest predictor of RHC-confirmed PH (odds ratio (OR) = 4.0, 95% CI: 1.17-13.69, P = 0.02 in the multivariable analysis).
CONCLUSIONS: This study adds to data that support the validity of abnormal HRR1 as a predictor of mortality and of RHC-confirmed PH in IPF. Research is needed to further investigate the link between abnormal HRR1 and PH and to elucidate heart-lung interactions at work during exercise and recovery in patients with IPF.
Jeffrey J Swigris; Amy L Olson; Oksana A Shlobin; Shahzad Ahmad; Kevin K Brown; Steven D Nathan
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Respirology (Carlton, Vic.)     Volume:  16     ISSN:  1440-1843     ISO Abbreviation:  Respirology     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-30     Completed Date:  2011-07-27     Revised Date:  2013-08-30    
Medline Journal Info:
Nlm Unique ID:  9616368     Medline TA:  Respirology     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  439-45     Citation Subset:  IM    
Copyright Information:
© 2011 The Authors. Respirology © 2011 Asian Pacific Society of Respirology.
Interstitial Lung Disease Program and Autoimmune Lung Center, National Jewish Health, Denver, Colorado 80206, USA.
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MeSH Terms
Cardiac Catheterization
Exercise Test / methods
Heart Rate / physiology*
Hypertension, Pulmonary / etiology,  mortality*
Idiopathic Pulmonary Fibrosis / complications,  mortality*
Middle Aged
Retrospective Studies
Sensitivity and Specificity
Survival Analysis
Walking / physiology*
Grant Support
Comment In:
Respirology. 2011 Apr;16(3):381-3   [PMID:  21299689 ]

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