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Nakagawa NK1, Rodrigues T1, Umeda IIK1, Andrade GN1, Nascimento JA1, Cahalin LP2
1Faculdade de Medicina da Universidade de São Paulo, Physiotherapy, Sao Paulo, Brazil, 2University of Miami Miller School of Medicine, Physiotherapy, Miami, United States
Background: Heart rate recovery at 1-minute (HRR1), heart rate recovery at 2-minute (HRR2) and walking distance from the six-minute walk test (6MW) have been indicated as strong prognostic markers of mortality in patients with heart failure (HF). We hypothesized that time-variation (minutes) between peak heart rate during the 6MW and recovery of rest heart rate (THRR) would be a more simple, easy and non-invasive marker to predict cardiac events (hospitalization and death) 12-month follow-up in patients with HF in the clinical setting.
Purpose: We aimed to investigate whether longer THRR could be used to predict cardiac events 12-months of follow up. We also determined the associations between THRR with HRR1, HRR2 and walking distance.
Methods: Fifty patients with HF (~59 y.o., NYHA II, LVEF ~35%) were submitted to 6MW and assessed for cardiac events and survival free-events after 12-months follow-up.
Results: Using the ROC curve, we examined the sensitivity and the specificity of the following variables: walking distance 561 m, HRR1 > 12, HRR2 > 22 and THRR ≥ 3-min for cardiac events. Walking distance were associated with HRR1 and HRR2 (r=0.48 and r=0.61, p 0.001), but weakly with THRR (r=-0.28 and p=0.025). The ROC curve analysis showed that THRR ≥ 3 min significantly predicted cardiac events 12-months follow up (ROC=0.80 of area with p=0.001) with higher sensitivity (0.76) and specificity (0.68) for cardiac events.
Conclusion(s): THRR ≥ 3 min is a simple, useful and strong predictor for cardiac events 12-months follow-up in patients with HF.
Implications: Simple, easy and non invasive assessments that may help to acurately predict cardiac events are very useful in the clinical setting. Patients with prolonged THRR (≥ 3 minutes) had a significantly greater risk for cardiac events than those HF patients with normal THRR (≤ 2 minutes).
Keywords: heart failure, heart rate recovery, six minutes walk test
Funding acknowledgements: FAPESP 2018/00553-3
Purpose: We aimed to investigate whether longer THRR could be used to predict cardiac events 12-months of follow up. We also determined the associations between THRR with HRR1, HRR2 and walking distance.
Methods: Fifty patients with HF (~59 y.o., NYHA II, LVEF ~35%) were submitted to 6MW and assessed for cardiac events and survival free-events after 12-months follow-up.
Results: Using the ROC curve, we examined the sensitivity and the specificity of the following variables: walking distance 561 m, HRR1 > 12, HRR2 > 22 and THRR ≥ 3-min for cardiac events. Walking distance were associated with HRR1 and HRR2 (r=0.48 and r=0.61, p 0.001), but weakly with THRR (r=-0.28 and p=0.025). The ROC curve analysis showed that THRR ≥ 3 min significantly predicted cardiac events 12-months follow up (ROC=0.80 of area with p=0.001) with higher sensitivity (0.76) and specificity (0.68) for cardiac events.
Conclusion(s): THRR ≥ 3 min is a simple, useful and strong predictor for cardiac events 12-months follow-up in patients with HF.
Implications: Simple, easy and non invasive assessments that may help to acurately predict cardiac events are very useful in the clinical setting. Patients with prolonged THRR (≥ 3 minutes) had a significantly greater risk for cardiac events than those HF patients with normal THRR (≤ 2 minutes).
Keywords: heart failure, heart rate recovery, six minutes walk test
Funding acknowledgements: FAPESP 2018/00553-3
Topic: Cardiorespiratory; Outcome measurement
Ethics approval required: Yes
Institution: Faculdade de Medicina da Universidade de São Paulo
Ethics committee: Comitê de Ética em Pesquisa da FMUSP
Ethics number: NCT02263482
All authors, affiliations and abstracts have been published as submitted.
