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Chronotropic incompetence (CI) relates to low-exercise capacity in heart failure (HF) patients. However, the impact for prognosis was not well elucidated.
One-hundred and twenty eight HF patients (mean age 67 years, 88 males) who underwent cardiopulmonary exercise testing were included. CI was defined as failure to achieve 80% of the maximum predicted heart rate (MPHR) for patients without beta-blocker, and 62% of MPHR for patients with beta-blocker. Endpoint was HF-related events, which including re-hospitalization or death due to HF.
CI was present in 56.3% of the population, and all cohorts were followed-up for mean duration of 17.6 months. At baseline, patients with CI had numerically low peak VO2 values (11.1 vs 12.2 mL/kg/min, P = 0.08) and significantly high VE/VCO2 slope (37.8 vs 33.9, P = 0.04) compare to patients without CI. Patients with CI had significantly worse prognosis compared to those without CI (Log-rank: P = 0.012). Presence of CI was independent predictor of worse prognosis (Hazard ratio: 2.52, 95% confidence interval: 1.21-5.25, P = 0.013) even adjusted by other factors including peak VO2 and VE/VCO2 slope.
CI was the significant predictor for worse prognosis in HF patient independent from exercise capacity.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: New Diagnostic and Imaging Strategies in Heart Failure
Abstract Category: 15. Heart Failure: Clinical
Presentation Number: 1136-302
- 2013 American College of Cardiology Foundation