BACKGROUND: Heart rate recovery (HRR) after exercise correlates with decreased vagal tone and mortality. Patients with COPD may have altered autonomic tone. We sought to determine the association of HRR with spirometry measures of pulmonary function. METHODS: We analyzed 627 patients (mean [+/- SD] age, 58 +/- 12 years; 65% men; mean FEV(1), 2.6 +/- 0.9 L, 80 +/- 20% predicted; patients receiving inhaled beta(2) agonist therapy, 10%; patients receiving inhaled anticholinergic therapy, 3%; patients receiving inhaled steroids, 5%; patients receiving oral prednisone, 4%) who had undergone maximal exercise testing and had undergone pulmonary function tests < 1 year apart. Patients with heart failure, pacemakers, and atrial fibrillation were excluded. Abnormal HRR was defined as a fall in heart rate during the first minute after exercise of <or= 12 beats/min (<or= 18 beats/min with stress echocardiography). Patients were divided into quartiles based on FEV(1) percent predicted. RESULTS: An abnormal HRR was seen in 229 patients (36%). The mean FEV(1) values broken into quartiles 1 to 4 were 54 +/- 11% predicted, 74 +/- 3% predicted, 87 +/- 4% predicted, and 106 +/- 10% predicted. In smokers and nonsmokers, a worsening FEV(1) percent predicted was associated with an abnormal HRR. In a multivariable model accounting for confounding factors including medications and functional capacity, the predictors of an abnormal HRR included FEV(1) percent predicted (adjusted odds ratio for 1 SD decrease, 1.32; 95% confidence interval, 1.07 to 1.65; p = 0.0004), impaired functional capacity, male gender, and age. CONCLUSIONS: Abnormalities found on spirometry are associated with abnormal HRR, which may reflect an altered autonomic tone associated with pulmonary dysfunction, either obstructive or restrictive in nature.
BACKGROUND: Heart rate recovery (HRR) after exercise correlates with decreased vagal tone and mortality. Patients with COPD may have altered autonomic tone. We sought to determine the association of HRR with spirometry measures of pulmonary function. METHODS: We analyzed 627 patients (mean [+/- SD] age, 58 +/- 12 years; 65% men; mean FEV(1), 2.6 +/- 0.9 L, 80 +/- 20% predicted; patients receiving inhaled beta(2) agonist therapy, 10%; patients receiving inhaled anticholinergic therapy, 3%; patients receiving inhaled steroids, 5%; patients receiving oral prednisone, 4%) who had undergone maximal exercise testing and had undergone pulmonary function tests < 1 year apart. Patients with heart failure, pacemakers, and atrial fibrillation were excluded. Abnormal HRR was defined as a fall in heart rate during the first minute after exercise of <or= 12 beats/min (<or= 18 beats/min with stress echocardiography). Patients were divided into quartiles based on FEV(1) percent predicted. RESULTS: An abnormal HRR was seen in 229 patients (36%). The mean FEV(1) values broken into quartiles 1 to 4 were 54 +/- 11% predicted, 74 +/- 3% predicted, 87 +/- 4% predicted, and 106 +/- 10% predicted. In smokers and nonsmokers, a worsening FEV(1) percent predicted was associated with an abnormal HRR. In a multivariable model accounting for confounding factors including medications and functional capacity, the predictors of an abnormal HRR included FEV(1) percent predicted (adjusted odds ratio for 1 SD decrease, 1.32; 95% confidence interval, 1.07 to 1.65; p = 0.0004), impaired functional capacity, male gender, and age. CONCLUSIONS: Abnormalities found on spirometry are associated with abnormal HRR, which may reflect an altered autonomic tone associated with pulmonary dysfunction, either obstructive or restrictive in nature.
Authors: Diego A Rodríguez; Eleni A Kortianou; Jennifer A Alison; Alejandro Casas; Santiago Giavedoni; Anael Barberan-Garcia; Ane Arbillaga; Jordi Vilaró; Elena Gimeno-Santos; Ioannis Vogiatzis; Roberto Rabinovich; Josep Roca Journal: Lung Date: 2017-06-17 Impact factor: 2.584
Authors: Jeffrey J Swigris; Jeff Swick; Frederick S Wamboldt; David Sprunger; Roland du Bois; Aryeh Fischer; Gregory P Cosgrove; Stephen K Frankel; Evans R Fernandez-Perez; Dolly Kervitsky; Kevin K Brown Journal: Chest Date: 2009-04-24 Impact factor: 9.410
Authors: José González-Costello; Hilary F Armstrong; Ulrich P Jorde; Anna C Bevelaqua; Laurie Letarte; Byron M Thomashow; Matthew N Bartels Journal: Respir Physiol Neurobiol Date: 2013-05-10 Impact factor: 1.931
Authors: Laís R G Ribeiro; Rafael B Mesquita; Laís S Vidotto; Myriam F Merli; Débora R Carvalho; Larissa A de Castro; Vanessa S Probst Journal: Braz J Phys Ther Date: 2015-03-13 Impact factor: 3.377
Authors: Dongxing Zhao; Asghar Abbasi; Richard Casaburi; Alessandra Adami; Nicholas B Tiller; Wei Yuan; Christopher Yee; Nicholas G Jendzjowsky; David M MacDonald; Ken M Kunisaki; William W Stringer; Janos Porszasz; Barry J Make; Russell P Bowler; Harry B Rossiter Journal: Int J Chron Obstruct Pulmon Dis Date: 2021-09-04