TY - JOUR
T1 - Cardiovascular mortality and chronotropic incompetence in systolic heart failure
T2 - The importance of a reappraisal of current cut-off criteria
AU - Magrì, Damiano
AU - Corrà, Ugo
AU - Di Lenarda, Andrea
AU - Cattadori, Gaia
AU - Maruotti, Antonello
AU - Iorio, Annamaria
AU - Mezzani, Alessandro
AU - Giannuzzi, Pantaleo
AU - Mantegazza, Valentina
AU - Gondoni, Erica
AU - Sinagra, Gianfranco
AU - Piepoli, Massimo F.
AU - Fiorentini, Cesare
AU - Agostoni, Piergiuseppe
PY - 2014
Y1 - 2014
N2 - Aims: An independent role for the exercise-induced heart rate (HR) response- and specifically the chronotropic incompetence (CI)-in the prognosis of heart failure (HF) is still debated. The multicentre study reported here sought to investigate the prognostic values of HR and CI variables on cardiovascular mortality in a large cohort of systolic HF patients. Methods A total of 1045 HF patients were recruited and prospectively followed in three Italian HF centres. The study endpoint and results: was cardiovascular mortality. Besides a full clinical examination, each patient underwent a maximal cardiopulmonary exercise test at study enrolment. The age-predicted peak HR (%pHR) and the peak HR reserve (%pHRR) according to different cut-off values (60-80% of the maximum predicted) were adopted to identify the presence of CI. The median follow-up was 876 days (interquartile range 386-1590 days). Cardiovascular death occurred in 145 cases (13.8%). Besides LVEF, peak oxygen uptake, ventilation vs. carbon dioxide production slope, and beta-blocker therapy, the multivariate analysis showed that both %pHR and %pHRR were able to predict prognosis when considered as continuous variables. Conversely, the presence of CI was associated with the study endpoint only when the 70% (%pHR
AB - Aims: An independent role for the exercise-induced heart rate (HR) response- and specifically the chronotropic incompetence (CI)-in the prognosis of heart failure (HF) is still debated. The multicentre study reported here sought to investigate the prognostic values of HR and CI variables on cardiovascular mortality in a large cohort of systolic HF patients. Methods A total of 1045 HF patients were recruited and prospectively followed in three Italian HF centres. The study endpoint and results: was cardiovascular mortality. Besides a full clinical examination, each patient underwent a maximal cardiopulmonary exercise test at study enrolment. The age-predicted peak HR (%pHR) and the peak HR reserve (%pHRR) according to different cut-off values (60-80% of the maximum predicted) were adopted to identify the presence of CI. The median follow-up was 876 days (interquartile range 386-1590 days). Cardiovascular death occurred in 145 cases (13.8%). Besides LVEF, peak oxygen uptake, ventilation vs. carbon dioxide production slope, and beta-blocker therapy, the multivariate analysis showed that both %pHR and %pHRR were able to predict prognosis when considered as continuous variables. Conversely, the presence of CI was associated with the study endpoint only when the 70% (%pHR
KW - Cardiopulmonary exercise test
KW - Chronotropic incompetence
KW - Heart failure
KW - Heart rate
KW - Prognosis
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U2 - 10.1002/ejhf.36
DO - 10.1002/ejhf.36
M3 - Article
C2 - 24464973
AN - SCOPUS:84897011489
VL - 16
SP - 201
EP - 209
JO - European Journal of Heart Failure
JF - European Journal of Heart Failure
SN - 1388-9842
IS - 2
ER -