Unreliability of the %VO2 reserve versus %heart rate reserve relationship for aerobic effort relative intensity assessment in chronic heart failure patients on or off beta-blocking therapy

Alessandro Mezzani, Ugo Corrà, Andrea Giordano, Michele Cafagna, Edvige Palazzo Adriano, Pantaleo Giannuzzi

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23 Citations (Scopus)

Abstract

BACKGROUND: Percentage of heart rate reserve (%HRR) has been shown to be equivalent to percentage of VO2 reserve (%VO2R) in normal individuals, but it is not clear whether this is also true for chronic heart failure (CHF) patients. DESIGN: This study aimed to evaluate the reliability of the %VO2R versus %HRR relationship for aerobic effort relative intensity assessment in CHF patients. METHODS: We studied 388 patients with CHF, of whom 213 were on carvedilol (CHF on βb) and 175 were off the drug (CHF off βb), and 40 normal individuals (N). %VO2R and %HRR values were evaluated at matched steps during cardiopulmonary exercise testing. The %VO2R versus %HRR regression was determined for each group (CHF, CHF on βb, CHF off βb, N) as a whole and as the mean of individual regressions. RESULTS: %VO2R strongly correlated with %HRR in both N and CHF, at both group and mean individual regressions, with slope and y-intercept values significantly lower and higher, respectively, in CHF than N. The 95% prediction interval of %VO2R for a given %HRR value was 24% points in N but rose to 41 in CHF, and the mean regression line coincided with identity line in N but not in CHF. These results were independent of beta-blockade. CONCLUSIONS: In CHF patients the %VO2R versus %HRR relationship is unreliable for assessment of aerobic effort relative intensity, because of a large prediction interval of %VO2R and lack of coincidence with the identity line, independently of beta-blocking therapy. This implies that the %VO2R versus %HRR relationship should be determined directly in each patient.

Original languageEnglish
Pages (from-to)92-98
Number of pages7
JournalEuropean Journal of Cardiovascular Prevention and Rehabilitation
Volume14
Issue number1
DOIs
Publication statusPublished - Feb 2007

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Heart Failure
Heart Rate
Therapeutics
Exercise

Keywords

  • Beta-blockers
  • Chronic heart failure
  • Heart rate reserve
  • Relative effort intensity
  • V reserve

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Rehabilitation
  • Public Health, Environmental and Occupational Health

Cite this

@article{97e8301c917a4b32a593015a7373267b,
title = "Unreliability of the {\%}VO2 reserve versus {\%}heart rate reserve relationship for aerobic effort relative intensity assessment in chronic heart failure patients on or off beta-blocking therapy",
abstract = "BACKGROUND: Percentage of heart rate reserve ({\%}HRR) has been shown to be equivalent to percentage of VO2 reserve ({\%}VO2R) in normal individuals, but it is not clear whether this is also true for chronic heart failure (CHF) patients. DESIGN: This study aimed to evaluate the reliability of the {\%}VO2R versus {\%}HRR relationship for aerobic effort relative intensity assessment in CHF patients. METHODS: We studied 388 patients with CHF, of whom 213 were on carvedilol (CHF on βb) and 175 were off the drug (CHF off βb), and 40 normal individuals (N). {\%}VO2R and {\%}HRR values were evaluated at matched steps during cardiopulmonary exercise testing. The {\%}VO2R versus {\%}HRR regression was determined for each group (CHF, CHF on βb, CHF off βb, N) as a whole and as the mean of individual regressions. RESULTS: {\%}VO2R strongly correlated with {\%}HRR in both N and CHF, at both group and mean individual regressions, with slope and y-intercept values significantly lower and higher, respectively, in CHF than N. The 95{\%} prediction interval of {\%}VO2R for a given {\%}HRR value was 24{\%} points in N but rose to 41 in CHF, and the mean regression line coincided with identity line in N but not in CHF. These results were independent of beta-blockade. CONCLUSIONS: In CHF patients the {\%}VO2R versus {\%}HRR relationship is unreliable for assessment of aerobic effort relative intensity, because of a large prediction interval of {\%}VO2R and lack of coincidence with the identity line, independently of beta-blocking therapy. This implies that the {\%}VO2R versus {\%}HRR relationship should be determined directly in each patient.",
keywords = "Beta-blockers, Chronic heart failure, Heart rate reserve, Relative effort intensity, V reserve",
author = "Alessandro Mezzani and Ugo Corr{\`a} and Andrea Giordano and Michele Cafagna and Adriano, {Edvige Palazzo} and Pantaleo Giannuzzi",
year = "2007",
month = "2",
doi = "10.1097/HJR.0b013e328011649b",
language = "English",
volume = "14",
pages = "92--98",
journal = "European Journal of Cardiovascular Prevention and Rehabilitation",
issn = "1741-8267",
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number = "1",

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TY - JOUR

T1 - Unreliability of the %VO2 reserve versus %heart rate reserve relationship for aerobic effort relative intensity assessment in chronic heart failure patients on or off beta-blocking therapy

AU - Mezzani, Alessandro

AU - Corrà, Ugo

AU - Giordano, Andrea

AU - Cafagna, Michele

AU - Adriano, Edvige Palazzo

AU - Giannuzzi, Pantaleo

PY - 2007/2

Y1 - 2007/2

N2 - BACKGROUND: Percentage of heart rate reserve (%HRR) has been shown to be equivalent to percentage of VO2 reserve (%VO2R) in normal individuals, but it is not clear whether this is also true for chronic heart failure (CHF) patients. DESIGN: This study aimed to evaluate the reliability of the %VO2R versus %HRR relationship for aerobic effort relative intensity assessment in CHF patients. METHODS: We studied 388 patients with CHF, of whom 213 were on carvedilol (CHF on βb) and 175 were off the drug (CHF off βb), and 40 normal individuals (N). %VO2R and %HRR values were evaluated at matched steps during cardiopulmonary exercise testing. The %VO2R versus %HRR regression was determined for each group (CHF, CHF on βb, CHF off βb, N) as a whole and as the mean of individual regressions. RESULTS: %VO2R strongly correlated with %HRR in both N and CHF, at both group and mean individual regressions, with slope and y-intercept values significantly lower and higher, respectively, in CHF than N. The 95% prediction interval of %VO2R for a given %HRR value was 24% points in N but rose to 41 in CHF, and the mean regression line coincided with identity line in N but not in CHF. These results were independent of beta-blockade. CONCLUSIONS: In CHF patients the %VO2R versus %HRR relationship is unreliable for assessment of aerobic effort relative intensity, because of a large prediction interval of %VO2R and lack of coincidence with the identity line, independently of beta-blocking therapy. This implies that the %VO2R versus %HRR relationship should be determined directly in each patient.

AB - BACKGROUND: Percentage of heart rate reserve (%HRR) has been shown to be equivalent to percentage of VO2 reserve (%VO2R) in normal individuals, but it is not clear whether this is also true for chronic heart failure (CHF) patients. DESIGN: This study aimed to evaluate the reliability of the %VO2R versus %HRR relationship for aerobic effort relative intensity assessment in CHF patients. METHODS: We studied 388 patients with CHF, of whom 213 were on carvedilol (CHF on βb) and 175 were off the drug (CHF off βb), and 40 normal individuals (N). %VO2R and %HRR values were evaluated at matched steps during cardiopulmonary exercise testing. The %VO2R versus %HRR regression was determined for each group (CHF, CHF on βb, CHF off βb, N) as a whole and as the mean of individual regressions. RESULTS: %VO2R strongly correlated with %HRR in both N and CHF, at both group and mean individual regressions, with slope and y-intercept values significantly lower and higher, respectively, in CHF than N. The 95% prediction interval of %VO2R for a given %HRR value was 24% points in N but rose to 41 in CHF, and the mean regression line coincided with identity line in N but not in CHF. These results were independent of beta-blockade. CONCLUSIONS: In CHF patients the %VO2R versus %HRR relationship is unreliable for assessment of aerobic effort relative intensity, because of a large prediction interval of %VO2R and lack of coincidence with the identity line, independently of beta-blocking therapy. This implies that the %VO2R versus %HRR relationship should be determined directly in each patient.

KW - Beta-blockers

KW - Chronic heart failure

KW - Heart rate reserve

KW - Relative effort intensity

KW - V reserve

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U2 - 10.1097/HJR.0b013e328011649b

DO - 10.1097/HJR.0b013e328011649b

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SN - 1741-8267

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