Chronotropic incompetence predicts impaired response to exercise training in heart failure patients in sinus rhythm

Schmid, Jean-Paul; Zurek, Marzena; Saner, Hugo (2012). Chronotropic incompetence predicts impaired response to exercise training in heart failure patients in sinus rhythm. European journal of preventive cardiology, 20(4), pp. 585-592. London: SAGE Publications 10.1177/2047487312444368

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Background: In most patients with chronic heart failure (CHF), endurance training improves exercise capacity. However, some patients do not respond favourably. The purpose of this study was to explore the reasons of non-response and to determine their predictive value.Methods: We studied a cohort of 120 consecutive CHF patients with sinus rhythm (mean age 57 ± 12 years, ejection fraction 29.3 ± 9.9%, peak VO2 17.3 ± 5.1 ml/min/kg), participating in a 3-month outpatient cardiac rehabilitation programme. Responders were defined as subjects who improved peak VO2 by more than 5%, work load by more than 10%, or VE/VCO2 slope by more than 5%. Subjects who did not fulfil at least one of the above criteria were characterized as non-responders. Multivariate regression analyses were performed to identify parameters that were predictive for a response. Receiver operating characteristic (ROC) analyses were performed for predictive parameters to identify thresholds for response or non-response.Results: Multivariate regression analyses revealed heart rate (HR) reserve, HR recovery at 1 min, and peak HR as significant predictors for a positive training response. ROC curves revealed the optimal thresholds separating responders from non-responders at less than 30 bpm for HR reserve, less than 6 bpm for HR recovery and less than 101 bpm for peak HR.Conclusions: The presence of impaired chronotropic competence is a major predictor of poor training response in CHF patients with sinus rhythm.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Schmid, Jean-Paul and Saner, Hugo

ISSN:

2047-4873

Publisher:

SAGE Publications

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:37

Last Modified:

08 Jun 2016 10:32

Publisher DOI:

10.1177/2047487312444368

PubMed ID:

22492866

Web of Science ID:

000321671400008

URI:

https://boris.unibe.ch/id/eprint/14989 (FactScience: 222138)

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