Heart rate response and functional capacity in patients with chronic heart failure with preserved ejection fraction
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Otros documentos de la autoría: Domínguez Mafé, Eloy; Palau, Patricia; Núñez, Eduardo; Ramón, José María; López, Laura; Melero, Joana; Bellver, Alejandro; Santas, Enrique; Chorro, Francisco J.; Núñez, Julio
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INVESTIGACIONMetadatos
Título
Heart rate response and functional capacity in patients with chronic heart failure with preserved ejection fractionAutoría
Fecha de publicación
2018Editor
WileyCita bibliográfica
DOMINGUEZ MAFÉ, Eloy; PALAU SAMPIO, Patricia; NÚÑEZ, Eduardo; RAMÓN, José María; LÓPEZ, Laura; MELERO, Joana; BELLVER, Alejandro; SANTAS, Enrique; CHORRO, Francisco J.; NÚÑEZ, Julio. (2018). Heart rate response and functional capacity in patients with chronic heart failure with preserved ejection fraction. ESC Heart Failure (2018), onlineTipo de documento
info:eu-repo/semantics/articleVersión de la editorial
https://onlinelibrary.wiley.com/doi/epdf/10.1002/ehf2.12281Versión
info:eu-repo/semantics/publishedVersionPalabras clave / Materias
Resumen
Aims: The 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 ... [+]
Aims: The 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 results
We prospectively studied 74 HFpEF patients [35.1% New York Heart Association Class III, 53% fe-
male, age (mean ± standard deviation) 72.5 ± 9.1 years, and 59.5% atrial
fi
brillation]. Functional performance was assessed
by peak oxygen consumption (peak VO
2
). The mean (standard deviation) peak VO
2
was 10 ± 2.8 mL/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
VO
2
was positively and signi
fi
cantly 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 VO
2
. We found a linear relationship between Delta-HR and peak VO
2
(
β
coef
fi
cient of
0.03; 95% con
fi
dence interval: 0.004
–
0.05;
P
= 0.030); conversely, the association among CIs and peak VO
2
was exponen-
tially shaped.
Conclusions
In patients with chronic HFpEF, the HR response to exercise was positively associated to patient
’
s functional
capacity. [-]
Publicado en
ESC Heart Failure (2018), onlineProyecto de investigación
This work was supported in part by grants from Sociedad Española de Cardiología: Investigación Clínica en Cardiología, Grant SEC 2015, CIBER CV 16/11/00420, 16/11/00403, FEDER, and PIE15/00013.Derechos de acceso
info:eu-repo/semantics/openAccess
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