Heart rate response and functional capacity in patients with chronic heart failure with preserved ejection fraction

AimsThe mechanisms of exercise intolerance in heart failure with preserved ejection fraction (HFpEF) are not yet elucidated. Chronotropic incompetence has emerged as a potential mechanism. We aimed to evaluate whether heart rate (HR) response to exercise is associated to functional capacity in patie...

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Autores: Domínguez E, Palau P, Núñez E, Ramón JM, López L, Melero J, Bellver A, Santas E, Chorro FJ, Núñez J
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2018
País:España
Institución:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p3166
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/3166
Access Level:acceso abierto
Palabra clave:Heart failure with preserved ejection fraction
Functional capacity
Chronotropic response
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spelling Heart rate response and functional capacity in patients with chronic heart failure with preserved ejection fractionDomínguez EPalau PNúñez ERamón JMLópez LMelero JBellver ASantas EChorro FJNúñez JHeart failure with preserved ejection fractionFunctional capacityChronotropic responseAimsThe mechanisms of exercise intolerance in heart failure with preserved ejection fraction (HFpEF) are not yet elucidated. Chronotropic incompetence has emerged as a potential mechanism. We aimed to evaluate whether heart rate (HR) response to exercise is associated to functional capacity in patients with symptomatic HFpEF. Methods and resultsWe prospectively studied 74 HFpEF patients [35.1% New York Heart Association Class III, 53% female, age (meanstandard deviation) 72.5 +/- 9.1years, and 59.5% atrial fibrillation]. Functional performance was assessed by peak oxygen consumption (peak VO2). The mean (standard deviation) peak VO2 was 10 +/- 2.8mL/min/kg. The following chronotropic parameters were calculated: Delta-HR (HR at peak exercise-HR at rest), chronotropic index (CI)=(HR at peak exercise-resting HR)/[(220-age)-resting HR], and CI according to the equation developed by Keteyian et al. (CIK) (HR at peak exercise-HR at rest)/[119+(HR at rest/2)-(age/2)-5-HR at rest]. In a bivariate setting, peak VO2 was positively and significantly correlated with Delta-HR (r=0.35, P=0.003), CI (r=0.27, P=0.022), CIK (r=0.28, P=0.018), and borderline with HR at peak exercise (r=0.22, P=0.055). In a multivariable linear regression analysis that included clinical, analytical, echocardiographic, and functional capacity covariates, the chronotropic parameters were positively associated with peak VO2. We found a linear relationship between Delta-HR and peak VO2 ( coefficient of 0.03; 95% confidence interval: 0.004-0.05; P=0.030); conversely, the association among CIs and peak VO2 was exponentially shaped. ConclusionsIn patients with chronic HFpEF, the HR response to exercise was positively associated to patient's functional capacity.WILEY PERIODICALS, INC2018info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fisabio.portalinvestigacion.com/publicaciones/3166ESC Heart FailureISSN: 20555822reponame:r-FISABIO. Repositorio Institucional de Producción Científicainstname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)Inglésinfo:eu-repo/semantics/openAccessoai:fisabio.fundanetsuite.com:p31662026-06-11T12:45:17Z
dc.title.none.fl_str_mv Heart rate response and functional capacity in patients with chronic heart failure with preserved ejection fraction
title Heart rate response and functional capacity in patients with chronic heart failure with preserved ejection fraction
spellingShingle Heart rate response and functional capacity in patients with chronic heart failure with preserved ejection fraction
Domínguez E
Heart failure with preserved ejection fraction
Functional capacity
Chronotropic response
title_short Heart rate response and functional capacity in patients with chronic heart failure with preserved ejection fraction
title_full Heart rate response and functional capacity in patients with chronic heart failure with preserved ejection fraction
title_fullStr Heart rate response and functional capacity in patients with chronic heart failure with preserved ejection fraction
title_full_unstemmed Heart rate response and functional capacity in patients with chronic heart failure with preserved ejection fraction
title_sort Heart rate response and functional capacity in patients with chronic heart failure with preserved ejection fraction
dc.creator.none.fl_str_mv Domínguez E
Palau P
Núñez E
Ramón JM
López L
Melero J
Bellver A
Santas E
Chorro FJ
Núñez J
author Domínguez E
author_facet Domínguez E
Palau P
Núñez E
Ramón JM
López L
Melero J
Bellver A
Santas E
Chorro FJ
Núñez J
author_role author
author2 Palau P
Núñez E
Ramón JM
López L
Melero J
Bellver A
Santas E
Chorro FJ
Núñez J
author2_role author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Heart failure with preserved ejection fraction
Functional capacity
Chronotropic response
topic Heart failure with preserved ejection fraction
Functional capacity
Chronotropic response
description AimsThe mechanisms of exercise intolerance in heart failure with preserved ejection fraction (HFpEF) are not yet elucidated. Chronotropic incompetence has emerged as a potential mechanism. We aimed to evaluate whether heart rate (HR) response to exercise is associated to functional capacity in patients with symptomatic HFpEF. Methods and resultsWe prospectively studied 74 HFpEF patients [35.1% New York Heart Association Class III, 53% female, age (meanstandard deviation) 72.5 +/- 9.1years, and 59.5% atrial fibrillation]. Functional performance was assessed by peak oxygen consumption (peak VO2). The mean (standard deviation) peak VO2 was 10 +/- 2.8mL/min/kg. The following chronotropic parameters were calculated: Delta-HR (HR at peak exercise-HR at rest), chronotropic index (CI)=(HR at peak exercise-resting HR)/[(220-age)-resting HR], and CI according to the equation developed by Keteyian et al. (CIK) (HR at peak exercise-HR at rest)/[119+(HR at rest/2)-(age/2)-5-HR at rest]. In a bivariate setting, peak VO2 was positively and significantly correlated with Delta-HR (r=0.35, P=0.003), CI (r=0.27, P=0.022), CIK (r=0.28, P=0.018), and borderline with HR at peak exercise (r=0.22, P=0.055). In a multivariable linear regression analysis that included clinical, analytical, echocardiographic, and functional capacity covariates, the chronotropic parameters were positively associated with peak VO2. We found a linear relationship between Delta-HR and peak VO2 ( coefficient of 0.03; 95% confidence interval: 0.004-0.05; P=0.030); conversely, the association among CIs and peak VO2 was exponentially shaped. ConclusionsIn patients with chronic HFpEF, the HR response to exercise was positively associated to patient's functional capacity.
publishDate 2018
dc.date.none.fl_str_mv 2018
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fisabio.portalinvestigacion.com/publicaciones/3166
url https://fisabio.portalinvestigacion.com/publicaciones/3166
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv WILEY PERIODICALS, INC
publisher.none.fl_str_mv WILEY PERIODICALS, INC
dc.source.none.fl_str_mv ESC Heart Failure
ISSN: 20555822
reponame:r-FISABIO. Repositorio Institucional de Producción Científica
instname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
instname_str Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
reponame_str r-FISABIO. Repositorio Institucional de Producción Científica
collection r-FISABIO. Repositorio Institucional de Producción Científica
repository.name.fl_str_mv
repository.mail.fl_str_mv
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