TY - JOUR
T1 - Relationship between diastolic function and heart rate recovery after symptom-limited exercise
AU - Gharacholou, S. Michael
AU - Scott, Christopher G.
AU - Borlaug, Barry A.
AU - Kane, Garvan C.
AU - McCully, Robert B.
AU - Oh, Jae K.
AU - Pellikka, Patricia A.
N1 - Funding Information:
The Mayo Clinic institutional review board approved this retrospective study. The study was supported by a grant from the Mayo Foundation. The authors are solely responsible for the design and conduct of this study, all study analyses, editing, drafting, and final contents of the manuscript.
PY - 2012/1
Y1 - 2012/1
N2 - 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.
AB - 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.
KW - Heart rate recovery
KW - diastolic function
KW - exercise echocardiography
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U2 - 10.1016/j.cardfail.2011.09.010
DO - 10.1016/j.cardfail.2011.09.010
M3 - Article
C2 - 22196839
AN - SCOPUS:84855655915
SN - 1071-9164
VL - 18
SP - 34
EP - 40
JO - Journal of Cardiac Failure
JF - Journal of Cardiac Failure
IS - 1
ER -