Heart rate recovery in pulmonary arterial hypertension: Relationship with exercise capacity and prognosis

Ramos, Roberta Pulcheri; Ota-­Arakaki, Jaquelina Sonoe; Barbosa, Priscila; Treptow, Erika; Valois, Fabrício Martins; Ferreira, Eloara Vieira Machado; Nery, Luíz Eduardo; Neder, J. Alberto

doi:10.1016/j.ahj.2012.01.023

Cited by 72 publications

(69 citation statements)

References 41 publications

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“…Abnormal HRR1 was also the strongest predictor of pulmonary hypertension in IPF on right heart catheterisation in multivariable analysis that included 6MWD (odds ratio 4.0, 95% CI 1.17-13.69; p50.02) [161]. In PAH, HRR following 6MWT was consistently slowed in PAH patients compared with controls, and the best cut-off of HRR1 to separate PAH patients from controls was 18 beats [162]. In 75 patients with IPAH, a HRR1 ,16 beats was found to be a strong predictor of clinical worsening [134].…”

Section: Dyspnoeamentioning

confidence: 93%

An official systematic review of the European Respiratory Society/American Thoracic Society: measurement properties of field walking tests in chronic respiratory disease

Singh¹,

Puhan²,

et al. 2014

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This systematic review examined the measurement properties of the 6-min walk test (6MWT), incremental shuttle walk test (ISWT) and endurance shuttle walk test (ESWT) in adults with chronic respiratory disease.Studies that report the evaluation or use of the 6MWT, ISWT or ESWT were included. We searched electronic databases for studies published between January 2000 and September 2013.The 6-min walking distance (6MWD) is a reliable measure (intra-class correlation coefficients ranged from 0.82 to 0.99 in seven studies). There is a learning effect, with greater distance walked on the second test (pooled mean improvement of 26 m in 13 studies). Reliability was similar for ISWT and ESWT, with a learning effect also evident for ISWT (pooled mean improvement of 20 m in six studies). The 6MWD correlates more strongly with peak work capacity (r50.59-0.93) and physical activity (r50.40-0.85) than with respiratory function (r50.10-0.59). Methodological factors affecting 6MWD include track length, encouragement, supplemental oxygen and walking aids. Supplemental oxygen also affects ISWT and ESWT performance. Responsiveness was moderate to high for all tests, with greater responsiveness to interventions that included exercise training.The findings of this review demonstrate that the 6MWT, ISWT and ESWT are robust tests of functional exercise capacity in adults with chronic respiratory disease. OverviewThe aim of this systematic review was to examine the measurement properties for the 6-min walk test (6MWT), incremental shuttle walk test (ISWT) and endurance shuttle walk test (ESWT) in adults with chronic respiratory disease. A companion paper describes the standard operating procedures for the tests [1]. The key findings of this systematic review are as follows.1) The 6-min walking distance (6MWD) is a valid and reliable measure of exercise capacity for people with chronic lung disease. The 6MWD correlates more strongly with measures of peak work capacity and physical activity than with respiratory function or quality of life, which supports its conceptualisation as a test of functional exercise performance.2) The ISWT offers a different protocol to the 6MWT as it is incremental and externally paced. The ISWT is a valid and reliable measure of cardiopulmonary exercise capacity in chronic obstructive pulmonary disease (COPD), where there is a strong relationship between ISWT distance and peak oxygen uptake (V9O 2 peak) or work rate on a cardiopulmonary exercise test (CPET).3) A learning effect is observed for the 6MWT and the ISWT. The second test usually is the better compared with the first, but this is inconsistent.4) The ESWT is a test of endurance capacity. It is externally paced and is performed along the same course as the ISWT. Two tests do not appear to be necessary if the second test is conducted on the same day.5) Reference equations have been proposed for the 6MWD and the ISWT. Age, height and weight are included in most equations. The influence of race and ethnicity is unclear.6) The safety profile of ...

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Section: Dyspnoeamentioning

confidence: 93%

An official systematic review of the European Respiratory Society/American Thoracic Society: measurement properties of field walking tests in chronic respiratory disease

Singh¹,

Puhan²,

et al. 2014

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“…Other measures of HR response include HR recovery (HRR), which is the reduction in HR with rest that occurs after the 6MWT is concluded. A reduced HRR during the first minute after the 6MWT has been associated with poor outcomes, including increased mortality, in ILD [49] and PAH [50,51]. However, there is not a universally accepted cut-off for HRR that is applicable across chronic respiratory diseases.…”

Section: Heart Ratementioning

confidence: 99%

An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease

Holland¹,

Spruit²,

Troosters³

et al. 2014

Eur Respir J

1,897

1,555

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Field walking tests are commonly employed to evaluate exercise capacity, assess prognosis and evaluate treatment response in chronic respiratory diseases. In recent years, there has been a wealth of new literature pertinent to the conduct of the 6-min walk test (6MWT), and a growing evidence base describing the incremental and endurance shuttle walk tests (ISWT and ESWT, respectively). The aim of this document is to describe the standard operating procedures for the 6MWT, ISWT and ESWT, which can be consistently employed by clinicians and researchers.The Technical Standard was developed by a multidisciplinary and international group of clinicians and researchers with expertise in the application of field walking tests. The procedures are underpinned by a concurrent systematic review of literature relevant to measurement properties and test conduct in adults with chronic respiratory disease.Current data confirm that the 6MWT, ISWT and ESWT are valid, reliable and responsive to change with some interventions. However, results are sensitive to small changes in methodology. It is important that two tests are conducted for the 6MWT and ISWT.This Technical Standard for field walking tests reflects current evidence regarding procedures that should be used to achieve robust results. OverviewThe aim of this Technical Standard is to document the standard operating procedures for the 6-min walk test (6MWT), incremental shuttle walk test (ISWT) and endurance shuttle walk test (ESWT) in adults with chronic respiratory disease. The testing procedures were developed by a multinational and multidisciplinary group of experts in field exercise testing, informed by a systematic review of the measurement properties and interpretation of the 6MWT, ISWT and ESWT in adults with chronic respiratory disease [1].The key findings of the Technical Standard are as follows.1) The 6-min walking distance (6MWD), ISWT and ESWT demonstrate good construct validity. Strong relationships with measures of exercise performance and physical activity support their conceptualisation as tests of functional exercise performance.2) A lower 6MWD is strongly associated with increased risk of hospitalisation and mortality in people with chronic respiratory disease, with a small number of studies suggesting a similar relationship for the ISWT.3) The 6MWD, ISWT and ESWT exhibit good test-retest reliability; however, there is strong evidence of a learning effect for the 6MWT and ISWT. Two tests should be performed when the 6MWT or ISWT are used to measure change over time.4) The 6MWD, ISWT and ESWT are responsive to treatment effects in people with chronic respiratory disease; however, most studies have evaluated responsiveness to rehabilitation and fewer data are available to confirm responsiveness to other interventions.5) The 6MWD and ISWT elicit a peak oxygen uptake (V9O 2 peak) that is similar to that during a cardiopulmonary exercise test (CPET). As a result, the contraindications and precautions for field testing should be consistent with those ...

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“…27,28 Changes in HRR indices have been evaluated in many other diseases and impairment of autonomic functions was found to be an independent predictor of CV mortality. 23,24,29,30 The association between ED and cardiac functions has been investigated more meticulously in recent years. Dogru et al 15 evaluated 65 men with ED and 70 control subjects by EST and reported that HRR1 was significantly lower in the ED population.…”

Section: Discussionmentioning

confidence: 99%

Deterioration of chronotropic responses and heart rate recovery indices in men with erectile dysfunction

Küçükdurmaz¹,

Açar²,

Resim³

2017

European Urology Supplements

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Heart rate recovery in pulmonary arterial hypertension: Relationship with exercise capacity and prognosis

Cited by 72 publications

References 41 publications

An official systematic review of the European Respiratory Society/American Thoracic Society: measurement properties of field walking tests in chronic respiratory disease

An official systematic review of the European Respiratory Society/American Thoracic Society: measurement properties of field walking tests in chronic respiratory disease

An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease

Deterioration of chronotropic responses and heart rate recovery indices in men with erectile dysfunction

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