Heart Rate Recovery at 1 Min after Exercise Is a Marker of Disease Severity and Prognosis in Chronic Thromboembolic Pulmonary Hypertension

Jin, Qi; Li, Xin; Zhang, Yi; Zhao, Zhihui; Zhao, Qing; Liu, Yan; Duan, Anqi; Luo, Qin; Liu, Zhihong

doi:10.1159/000520314

Cited by 8 publications

(7 citation statements)

References 26 publications

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“…Better levels of aerobic fitness act beneficially on the autonomic control of post-exercise HR, preserving the vagal reentry velocity in healthy middle-aged adults [ 10 ]. Thus, there is scientific evidence to accept the association between HRR and prognosis of cardiovascular disease, which supports the recommendation of recording HRR for risk assessment in clinical practice, as a routine [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 75%

Validation of StepTest4all for Assessing Cardiovascular Capacity in Young Adults

Bragada

Bartolomeu

Rodrigues

et al. 2022

IJERPH

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Background: Cardiovascular capacity, expressed as maximal oxygen uptake (VO2max), is a strong predictor of health and fitness and is considered a key measure of physiological function in the healthy adult population. The purpose of this study was to validate a specific step test (StepTest4all) as an adequate procedure to estimate cardiovascular capacity in young adults. Methods: The sample was composed of 56 participants, including 19 women (aged 21.05 ± 2.39 years, body mass = 57.50 ± 6.64 kg, height = 1.62 ± 0.05 m, body mass index = 22.00 ± 2.92 kg/m2) and 37 men (aged 22.05 ± 3.14 years, body mass = 72.50 ± 7.73 kg, height = 1.76 ± 0.07 m, body mass index = 23.34 ± 2.17 kg/m2). Participants were included in one of the following groups: (i) the group used to predict the VO2max, and (ii) the group used to validate the prediction model. All participants performed the StepTest4all protocol. The step height and the intensity of the effort was determined individually. Heart rate and oxygen uptake were measured continuously during rest, effort, and recovery phases. The validation process included the following three stages: (i) mean data comparison, (ii) simple linear regression, and (iii) Bland–Altman analysis. Results: The linear regression retained, as significant predictors of the VO2max, sex (p < 0.001) and heart rate recovery for one minute (p = 0.003). The prediction equation revealed a high relationship between measurements (R2 = 63.0%, SEE = 5.58). The validation procedure revealed non-significant differences (p > 0.05) between the measured and estimated maximal oxygen uptake, high relationship (R2 = 63.3%), and high agreement with Bland–Altman plots. Thus, VO2max can be estimated with the formula: VO2max = 22 + 0.3 · (HRR1min) + 12 · (sex), where HRR1min is the magnitude of the HR decrease (bpm) in one minute immediately after the step was stopped, and sex: men = 1, women = 0. Conclusions: The StepTest4all is an adequate procedure to estimate cardiovascular capacity, expressed as VO2max, in young adults. In addition, it is possible to determine the qualitative level of cardiovascular capacity from the heart rate recovery for one minute, more specifically, poor: <20, moderate: 20 to 34, good: 35 to 49, and excellent: ≥50. This procedure has the benefit of being simple to apply and can be used by everyone, even at home, without specialist supervision.

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Section: Introductionmentioning

confidence: 75%

Validation of StepTest4all for Assessing Cardiovascular Capacity in Young Adults

Bragada

Bartolomeu

Rodrigues

et al. 2022

IJERPH

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“…Additionally, Inagaki et al also reported that HRR1 was correlated with hemodynamics in CTEPH (group IV pulmonary hypertension) (18). Recently, we reported that HRR1 could independently predict prognosis in patients with CTEPH (19). However, to the best of our knowledge, no one has systematically studied the interaction between BPA and cardiac autonomic function.…”

Section: Introductionmentioning

confidence: 93%

Heart-Rate Recovery at 1 Min After Exercise Predicts Response to Balloon Pulmonary Angioplasty in Patients With Inoperable Chronic Thromboembolic Pulmonary Hypertension

Zhang

Luo

et al. 2022

Front. Cardiovasc. Med.

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BackgroundDysfunction of autonomic nervous system plays an important role in the development of pulmonary hypertension. The present study aimed to investigate the interaction between balloon pulmonary angioplasty (BPA) and cardiac autonomic function by using heart-rate recovery at 1 min (HRR1) after exercise as a surrogate marker.Methods and ResultsWe retrospectively enrolled 89 consecutive patients with inoperable chronic thromboembolic pulmonary hypertension who underwent BPA from May, 2018 to Jan, 2021. According to hemodynamics at follow-up, patients were categorized as BPA responders if they met one or both of the following criteria: (1) mean pulmonary arterial pressure ≤ 30 mmHg and (2) a reduction of pulmonary vascular resistance ≥ 30%. Compared with baseline, HRR1 tended to increase within 7 days after the first BPA session, and this improvement persisted at follow-up. HRR1 at baseline and at follow-up were associated with well-validated markers of CTEPH severity, including N-terminal pro-brain natriuretic peptide, mean pulmonary arterial pressure and pulmonary vascular resistance. Furthermore, the change of HRR1 from baseline to follow-up was also associated with the change of those variables. After adjustment for confounders, baseline HRR1 was still a strong independent predictor of BPA outcome. Receiver operator characteristic curve analysis showed that the cutoff value for HRR1 in predicting BPA outcome was 19 beats.ConclusionsBPA could significantly improve HRR1, suggesting the alleviation of sympathovagal imbalance. Easily available and non-invasive HRR1 seems to be a useful tool in predicting outcome of BPA and dynamically monitoring the efficacy of BPA.

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“…Slow HRR has been defined as a reduction in HR 1 minute after the end of exercise from HR at peak exercise (HR peak ) of less than 12 or 14 bpm ( Cole et al, 1999 ). There is evidence suggesting that slow HRR is a prognostic marker in different diseases, such as coronary artery disease, heart failure, and chronic thromboembolic pulmonary hypertension, as well as in individuals with chronic obstructive pulmonary disease (COPD) ( Morshedi-Meibodi et al, 2002 ; Seshadri et al, 2004 ; Lacasse et al, 2005 ; Nanas et al, 2006 ; Lachman et al, 2018 ; Jin et al, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

Effect of pulmonary rehabilitation on heart rate recovery in adult individuals with asthma or chronic obstructive pulmonary disease

Zampogna

Ambrosino²,

Oliva³

et al. 2022

Front. Pharmacol.

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Introduction: Heart rate recovery (HRR) after exercise is a marker of disease severity and prognosis in cardiovascular and respiratory disorders. More than 30% of adult individuals with asthma may show a slow HRR. Pulmonary rehabilitation improves exercise capacity in individuals with asthma or chronic obstructive pulmonary disease (COPD).Aim: The study aimed to evaluate the effect of pulmonary rehabilitation on HRR in individuals with asthma as compared to those with COPD.Methods: Retrospective analysis of HRR one minute after the six-minute walking test (6MWT) was performed before and after an exercise training program. The COPD Assessment Test (CAT), Barthel Index-Dyspnea (BI-D), Medical Research Council (MRC) score for dyspnea, and the Five-Times-Sit-to-Stand test (5STS) were also assessed as secondary outcome measures.Results: Slow HRR prevalence was significantly lower in individuals with asthma than with COPD (29.1 vs. 46.7%, respectively: p = 0.003). Post-program HRR did not change in more than 70% of individuals in either population and improved in 16% of both populations, whereas it actually worsened in 12 and 10% of individuals with asthma and COPD, respectively. The outcome measures significantly improved in both populations, irrespective of baseline HRR.Conclusion: In individuals with asthma or COPD, exercise training does not significantly improve HRR.

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Heart Rate Recovery at 1 Min after Exercise Is a Marker of Disease Severity and Prognosis in Chronic Thromboembolic Pulmonary Hypertension

Cited by 8 publications

References 26 publications

Validation of StepTest4all for Assessing Cardiovascular Capacity in Young Adults

Validation of StepTest4all for Assessing Cardiovascular Capacity in Young Adults

Heart-Rate Recovery at 1 Min After Exercise Predicts Response to Balloon Pulmonary Angioplasty in Patients With Inoperable Chronic Thromboembolic Pulmonary Hypertension

Effect of pulmonary rehabilitation on heart rate recovery in adult individuals with asthma or chronic obstructive pulmonary disease

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