Document Detail

Relationship between diastolic function and heart rate recovery after symptom-limited exercise.
MedLine Citation:
PMID:  22196839     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Autonomic abnormalities have been implicated in both diastolic dysfunction and abnormal heart rate (HR) recovery; however, few studies have assessed whether diastolic dysfunction is associated with abnormal HR recovery and whether both modify exercise capacity.
METHODS AND RESULTS: Exercise echocardiography with diastolic assessment was performed in 2,826 patients with normal wall motion responses to symptom-limited exercise testing. HR recovery was defined as the difference in HR from peak exercise to 1 minute in recovery; abnormal HR recovery was defined as the lowest quartile. Mean HR recovery was 32 ± 14 beats per minute. Patients with diastolic dysfunction or abnormal HR recovery had lower exercise capacity, and those with both had the lowest exercise capacity (P < .0001 compared with normal responses). Indices of abnormal diastolic function were correlated with abnormal HR recovery. In multivariable analysis, after age diastolic dysfunction (referent: normal diastolic function) was the strongest predictor of abnormal HR recovery (adjusted odds ratio [OR] 1.47, 95% confidence interval [CI] 1.20-1.80) and incrementally predictive of chronotropic incompetence (adjusted OR 1.42, 95% CI 1.16-1.74).
CONCLUSIONS: Diastolic dysfunction is independently associated with abnormal HR recovery after symptom-limited exercise. Further studies are needed to determine if diastolic function modifies the adverse outcomes observed in those with abnormal HR recovery.
S Michael Gharacholou; Christopher G Scott; Barry A Borlaug; Garvan C Kane; Robert B McCully; Jae K Oh; Patricia A Pellikka
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural     Date:  2011-11-09
Journal Detail:
Title:  Journal of cardiac failure     Volume:  18     ISSN:  1532-8414     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2011-12-26     Completed Date:  2012-05-03     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  34-40     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Echocardiography and Hemodynamic Laboratory, Division of Cardiovascular Diseases and Internal Medicine, Rochester, Minnesota, USA.
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MeSH Terms
Cohort Studies
Exercise Test
Exercise Tolerance*
Heart Rate*
Middle Aged
Predictive Value of Tests
Retrospective Studies
Ventricular Dysfunction, Left / physiopathology*
Grant Support
1L30 AG034828-01/AG/NIA NIH HHS; L30 AG034828-01/AG/NIA NIH HHS

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