Abstract
AimsHeart rate recovery (HRR) appears to be a robust prognostic marker in heart failure (HF). When using the 6 min walk test (6MWT) in HF, distance ambulated is generally the reference prognostic variable. We hypothesized that HRR after the 6MWT would be a better prognostic measure than distance ambulated.Methods and resultsA 6MWT and cardiopulmonary exercise testing (CPX) were randomly performed in 258 HF patients [216 HF with reduced EF (HFrEF) and 42 HF preserved EF (HFpEF)], after which HRR was measured. HRR was defined as the difference between heart rate at peak exercise and 1 min following test termination. Patients were assessed for major cardiac events during a mean follow-up period of 22.8 ± 22.1 months. There were 50 major cardiac events during the tracking period. Univariate Cox regression analysis results identified HRR after both the 6MWT and CPX as a significant (P <0.001) predictor of adverse events. Multivariate Cox regression analysis revealed that dichotomized HRR after the 6MWT and CPX was the strongest predictor of survival (χ2 61.1 and 53.8, respectively; P <0.001), with LVEF (residual χ2 6.1, P <0.05) adding significant prognostic value to the 6MWT model and ventilatory efficiency (the VE/VCO2 slope) (residual χ2 6.6, P <0. 05) adding significant prognostic value to the CPX model.ConclusionsHRR after the 6MWT is a powerful prognosticator that performs similarly to HRR after maximal exercise. If confirmed in subsequent studies, 6MWT HRR should replace 6MWT distance as the reference criterion 6MWT measure to consider when grading cardiovascular risk in HF patients. All rights reserved.
| Original language | English |
|---|---|
| Pages (from-to) | 519-527 |
| Number of pages | 9 |
| Journal | European Journal of Heart Failure |
| Volume | 15 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - May 2013 |
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Keywords
- 6 Min walk test
- Cardiopulmonary exercise test
- Heart failure
- Heart rate recovery
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Heart rate recovery after the 6 min walk test rather than distance ambulated is a powerful prognostic indicator in heart failure with reduced and preserved ejection fraction : A comparison with cardiopulmonary exercise testing. / Cahalin, Lawrence P.; Arena, Ross; Labate, Valentina; Bandera, Francesco; Lavie, Carl J.; Guazzi, Marco.
In: European Journal of Heart Failure, Vol. 15, No. 5, 05.2013, p. 519-527.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Heart rate recovery after the 6 min walk test rather than distance ambulated is a powerful prognostic indicator in heart failure with reduced and preserved ejection fraction
T2 - A comparison with cardiopulmonary exercise testing
AU - Cahalin, Lawrence P.
AU - Arena, Ross
AU - Labate, Valentina
AU - Bandera, Francesco
AU - Lavie, Carl J.
AU - Guazzi, Marco
PY - 2013/5
Y1 - 2013/5
N2 - AimsHeart rate recovery (HRR) appears to be a robust prognostic marker in heart failure (HF). When using the 6 min walk test (6MWT) in HF, distance ambulated is generally the reference prognostic variable. We hypothesized that HRR after the 6MWT would be a better prognostic measure than distance ambulated.Methods and resultsA 6MWT and cardiopulmonary exercise testing (CPX) were randomly performed in 258 HF patients [216 HF with reduced EF (HFrEF) and 42 HF preserved EF (HFpEF)], after which HRR was measured. HRR was defined as the difference between heart rate at peak exercise and 1 min following test termination. Patients were assessed for major cardiac events during a mean follow-up period of 22.8 ± 22.1 months. There were 50 major cardiac events during the tracking period. Univariate Cox regression analysis results identified HRR after both the 6MWT and CPX as a significant (P <0.001) predictor of adverse events. Multivariate Cox regression analysis revealed that dichotomized HRR after the 6MWT and CPX was the strongest predictor of survival (χ2 61.1 and 53.8, respectively; P <0.001), with LVEF (residual χ2 6.1, P <0.05) adding significant prognostic value to the 6MWT model and ventilatory efficiency (the VE/VCO2 slope) (residual χ2 6.6, P <0. 05) adding significant prognostic value to the CPX model.ConclusionsHRR after the 6MWT is a powerful prognosticator that performs similarly to HRR after maximal exercise. If confirmed in subsequent studies, 6MWT HRR should replace 6MWT distance as the reference criterion 6MWT measure to consider when grading cardiovascular risk in HF patients. All rights reserved.
AB - AimsHeart rate recovery (HRR) appears to be a robust prognostic marker in heart failure (HF). When using the 6 min walk test (6MWT) in HF, distance ambulated is generally the reference prognostic variable. We hypothesized that HRR after the 6MWT would be a better prognostic measure than distance ambulated.Methods and resultsA 6MWT and cardiopulmonary exercise testing (CPX) were randomly performed in 258 HF patients [216 HF with reduced EF (HFrEF) and 42 HF preserved EF (HFpEF)], after which HRR was measured. HRR was defined as the difference between heart rate at peak exercise and 1 min following test termination. Patients were assessed for major cardiac events during a mean follow-up period of 22.8 ± 22.1 months. There were 50 major cardiac events during the tracking period. Univariate Cox regression analysis results identified HRR after both the 6MWT and CPX as a significant (P <0.001) predictor of adverse events. Multivariate Cox regression analysis revealed that dichotomized HRR after the 6MWT and CPX was the strongest predictor of survival (χ2 61.1 and 53.8, respectively; P <0.001), with LVEF (residual χ2 6.1, P <0.05) adding significant prognostic value to the 6MWT model and ventilatory efficiency (the VE/VCO2 slope) (residual χ2 6.6, P <0. 05) adding significant prognostic value to the CPX model.ConclusionsHRR after the 6MWT is a powerful prognosticator that performs similarly to HRR after maximal exercise. If confirmed in subsequent studies, 6MWT HRR should replace 6MWT distance as the reference criterion 6MWT measure to consider when grading cardiovascular risk in HF patients. All rights reserved.
KW - 6 Min walk test
KW - Cardiopulmonary exercise test
KW - Heart failure
KW - Heart rate recovery
UR - http://www.scopus.com/inward/record.url?scp=84877115232&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84877115232&partnerID=8YFLogxK
U2 - 10.1093/eurjhf/hfs216
DO - 10.1093/eurjhf/hfs216
M3 - Article
C2 - 23397578
AN - SCOPUS:84877115232
VL - 15
SP - 519
EP - 527
JO - European Journal of Heart Failure
JF - European Journal of Heart Failure
SN - 1388-9842
IS - 5
ER -