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The importance of heart rate recovery in patients with heart failure or left ventricular systolic dysfunction.
J Card Fail. 2005 Oct; 11(8):624-30.JC

Abstract

BACKGROUND

The ability to better predict outcome with exercise testing in patients with heart failure (HF) and left ventricular systolic dysfunction (LVSD) may prove extremely valuable in determining which patients are at increased risk. This study evaluated the ability of heart rate recovery (HRR) to predict outcome in patients with HF and validate previous findings in LVSD.

METHODS AND RESULTS

HRR was measured at 1-, 2-, 3-, and 5-minute time points after treadmill testing in 2,193 males being evaluated for chest pain at the Palo Alto and Long Beach VA Hospitals. Left ventricular ejection fraction (LVEF) was calculated using biplane ventriculography and patients were considered to have LVSD if they had an LVEF <50%. Angiographic and clinical data was available for all patients. Of the 2,193 patients, 314 patients had LVSD and 109 had a history of HF. Both HF patients and patients with LVSD with a normal HRR at 2 minutes had improved survival compared with patients that had an abnormal HRR at 2 minutes when adjusted for age and beta-blocker use (HF adjusted odds ratio 0.25, 95% CI 0.10-0.66, P < .006; LVSD alone adjusted odds ratio 0.25, 95% CI 0.13-0.47, P < .0001). Stepwise proportional hazard regression analysis revealed that only 2-minute HRR, age, LVEF, and chronic obstructive pulmonary disorder were significant predictors of mortality in patients with LVSD and only HRR at 2 minutes and LV hypertrophy were significant predictors of mortality in patients with HF.

CONCLUSION

HRR is a significant predictor of mortality in patients with HF and patients with LVSD and may be useful in better determining prognosis.

Authors+Show Affiliations

Division of Cardiology, Veterans Affairs Palo Alto Health Care System, Stanford University, Palo Alto, California 94304, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

16230267

Citation

Lipinski, Michael J., et al. "The Importance of Heart Rate Recovery in Patients With Heart Failure or Left Ventricular Systolic Dysfunction." Journal of Cardiac Failure, vol. 11, no. 8, 2005, pp. 624-30.
Lipinski MJ, Vetrovec GW, Gorelik D, et al. The importance of heart rate recovery in patients with heart failure or left ventricular systolic dysfunction. J Card Fail. 2005;11(8):624-30.
Lipinski, M. J., Vetrovec, G. W., Gorelik, D., & Froelicher, V. F. (2005). The importance of heart rate recovery in patients with heart failure or left ventricular systolic dysfunction. Journal of Cardiac Failure, 11(8), 624-30.
Lipinski MJ, et al. The Importance of Heart Rate Recovery in Patients With Heart Failure or Left Ventricular Systolic Dysfunction. J Card Fail. 2005;11(8):624-30. PubMed PMID: 16230267.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The importance of heart rate recovery in patients with heart failure or left ventricular systolic dysfunction. AU - Lipinski,Michael J, AU - Vetrovec,George W, AU - Gorelik,Dmitry, AU - Froelicher,Victor F, PY - 2004/07/06/received PY - 2005/05/16/revised PY - 2005/06/06/accepted PY - 2005/10/19/pubmed PY - 2006/5/23/medline PY - 2005/10/19/entrez SP - 624 EP - 30 JF - Journal of cardiac failure JO - J. Card. Fail. VL - 11 IS - 8 N2 - BACKGROUND: The ability to better predict outcome with exercise testing in patients with heart failure (HF) and left ventricular systolic dysfunction (LVSD) may prove extremely valuable in determining which patients are at increased risk. This study evaluated the ability of heart rate recovery (HRR) to predict outcome in patients with HF and validate previous findings in LVSD. METHODS AND RESULTS: HRR was measured at 1-, 2-, 3-, and 5-minute time points after treadmill testing in 2,193 males being evaluated for chest pain at the Palo Alto and Long Beach VA Hospitals. Left ventricular ejection fraction (LVEF) was calculated using biplane ventriculography and patients were considered to have LVSD if they had an LVEF <50%. Angiographic and clinical data was available for all patients. Of the 2,193 patients, 314 patients had LVSD and 109 had a history of HF. Both HF patients and patients with LVSD with a normal HRR at 2 minutes had improved survival compared with patients that had an abnormal HRR at 2 minutes when adjusted for age and beta-blocker use (HF adjusted odds ratio 0.25, 95% CI 0.10-0.66, P < .006; LVSD alone adjusted odds ratio 0.25, 95% CI 0.13-0.47, P < .0001). Stepwise proportional hazard regression analysis revealed that only 2-minute HRR, age, LVEF, and chronic obstructive pulmonary disorder were significant predictors of mortality in patients with LVSD and only HRR at 2 minutes and LV hypertrophy were significant predictors of mortality in patients with HF. CONCLUSION: HRR is a significant predictor of mortality in patients with HF and patients with LVSD and may be useful in better determining prognosis. SN - 1071-9164 UR - https://www.unboundmedicine.com/medline/citation/16230267/The_importance_of_heart_rate_recovery_in_patients_with_heart_failure_or_left_ventricular_systolic_dysfunction_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1071-9164(05)00676-7 DB - PRIME DP - Unbound Medicine ER -