Chronotropic incompetence predicts mortality in severe obstructive pulmonary disease

We evaluated the prevalence of chronotropic incompetence (CI), a marker of autonomic dysfunction, and its prognostic value in patients with chronic obstructive pulmonary disease (COPD). We performed a retrospective analysis of 449 patients with severe COPD who underwent a cardiopulmonary exercise te...

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Autores: González-Costello, José, Armstrong, Hilary F., Jorde, Ulrich P., Bevelaqua, Anna C., Letarte, Laurie, Thomashow, Byron M., Bartels, Matthew N.
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2013
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/126452
Acceso en línea:https://hdl.handle.net/2445/126452
Access Level:acceso abierto
Palabra clave:Malalties pulmonars obstructives cròniques
Mortalitat
Chronic obstructive pulmonary diseases
Mortality
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spelling Chronotropic incompetence predicts mortality in severe obstructive pulmonary diseaseGonzález-Costello, JoséArmstrong, Hilary F.Jorde, Ulrich P.Bevelaqua, Anna C.Letarte, LaurieThomashow, Byron M.Bartels, Matthew N.Malalties pulmonars obstructives cròniquesMortalitatChronic obstructive pulmonary diseasesMortalityWe evaluated the prevalence of chronotropic incompetence (CI), a marker of autonomic dysfunction, and its prognostic value in patients with chronic obstructive pulmonary disease (COPD). We performed a retrospective analysis of 449 patients with severe COPD who underwent a cardiopulmonary exercise test, after excluding patients with lung volume reduction surgery, left ventricular dysfunction and those not in sinus rhythm. CI was defined as percent predicted heart rate reserve (%HRR). Events were defined as death or lung transplant during a median follow-up of 68 months. Median age was 61 years; median percent predicted forced expiratory volume in one second (%FEV1) of 25% and median %HRR of 33%. The hazard ratio for an event in the lowest quartile of %HRR, taking the highest quartile as reference, was of 3.2 (95% confidence interval: 2.1-4.8; p < 0.001). In a multivariate regression model, %HRR was an independent predictor of events. In conclusion, Cl was an independent and powerful outcome predictor in patients with severe COPD. (C) 2013 Elsevier B.V. All rights reserved.Elsevier Science2013info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersionapplication/pdfhttps://hdl.handle.net/2445/126452Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésVersió postprint del document publicat a: https://doi.org/10.1016/j.resp.2013.05.002Respiratory Physiology & Neurobiology, 2013, vol. 188, num. 2, p. 113-118https://doi.org/10.1016/j.resp.2013.05.002(c) Elsevier, 2013info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1264522026-05-27T06:46:51Z
dc.title.none.fl_str_mv Chronotropic incompetence predicts mortality in severe obstructive pulmonary disease
title Chronotropic incompetence predicts mortality in severe obstructive pulmonary disease
spellingShingle Chronotropic incompetence predicts mortality in severe obstructive pulmonary disease
González-Costello, José
Malalties pulmonars obstructives cròniques
Mortalitat
Chronic obstructive pulmonary diseases
Mortality
title_short Chronotropic incompetence predicts mortality in severe obstructive pulmonary disease
title_full Chronotropic incompetence predicts mortality in severe obstructive pulmonary disease
title_fullStr Chronotropic incompetence predicts mortality in severe obstructive pulmonary disease
title_full_unstemmed Chronotropic incompetence predicts mortality in severe obstructive pulmonary disease
title_sort Chronotropic incompetence predicts mortality in severe obstructive pulmonary disease
dc.creator.none.fl_str_mv González-Costello, José
Armstrong, Hilary F.
Jorde, Ulrich P.
Bevelaqua, Anna C.
Letarte, Laurie
Thomashow, Byron M.
Bartels, Matthew N.
author González-Costello, José
author_facet González-Costello, José
Armstrong, Hilary F.
Jorde, Ulrich P.
Bevelaqua, Anna C.
Letarte, Laurie
Thomashow, Byron M.
Bartels, Matthew N.
author_role author
author2 Armstrong, Hilary F.
Jorde, Ulrich P.
Bevelaqua, Anna C.
Letarte, Laurie
Thomashow, Byron M.
Bartels, Matthew N.
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv Malalties pulmonars obstructives cròniques
Mortalitat
Chronic obstructive pulmonary diseases
Mortality
topic Malalties pulmonars obstructives cròniques
Mortalitat
Chronic obstructive pulmonary diseases
Mortality
description We evaluated the prevalence of chronotropic incompetence (CI), a marker of autonomic dysfunction, and its prognostic value in patients with chronic obstructive pulmonary disease (COPD). We performed a retrospective analysis of 449 patients with severe COPD who underwent a cardiopulmonary exercise test, after excluding patients with lung volume reduction surgery, left ventricular dysfunction and those not in sinus rhythm. CI was defined as percent predicted heart rate reserve (%HRR). Events were defined as death or lung transplant during a median follow-up of 68 months. Median age was 61 years; median percent predicted forced expiratory volume in one second (%FEV1) of 25% and median %HRR of 33%. The hazard ratio for an event in the lowest quartile of %HRR, taking the highest quartile as reference, was of 3.2 (95% confidence interval: 2.1-4.8; p < 0.001). In a multivariate regression model, %HRR was an independent predictor of events. In conclusion, Cl was an independent and powerful outcome predictor in patients with severe COPD. (C) 2013 Elsevier B.V. All rights reserved.
publishDate 2013
dc.date.none.fl_str_mv 2013
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/126452
url https://hdl.handle.net/2445/126452
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Versió postprint del document publicat a: https://doi.org/10.1016/j.resp.2013.05.002
Respiratory Physiology & Neurobiology, 2013, vol. 188, num. 2, p. 113-118
https://doi.org/10.1016/j.resp.2013.05.002
dc.rights.none.fl_str_mv (c) Elsevier, 2013
info:eu-repo/semantics/openAccess
rights_invalid_str_mv (c) Elsevier, 2013
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Elsevier Science
publisher.none.fl_str_mv Elsevier Science
dc.source.none.fl_str_mv Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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