Elsevier

Respiratory Medicine

Volume 99, Issue 7, July 2005, Pages 877-886
Respiratory Medicine

Post-exercise heart rate recovery and mortality in chronic obstructive pulmonary disease

https://doi.org/10.1016/j.rmed.2004.11.012Get rights and content
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Summary

Abnormal heart rate recovery (HRR) after exercise, a marker of cardiac autonomic dysfunction, is associated with poor prognosis in various populations. As chronic obstructive pulmonary disease (COPD) is associated with cardiac autonomic dysfunction, we tested the hypothesis that patients with COPD have a lower HRR than healthy people, and evaluated whether a delay in HRR is associated with an increased risk of mortality in COPD. The records of 147 COPD patients were reviewed (65.1±9.1 years, mean±sd, 42 women/105 men, forced expiratory volume in 1 s (FEV1): 42±15% predicted) and compared to 25 healthy subjects (61.6±4.5 years, 5 women/20 men, FEV1: 100±14% predicted) during recovery after an exercise test. Heart rate was measured at peak exercise and at 1-min recovery, the difference between the two being defined as HRR (11±9 beats in COPD patients vs. 20±9 beats in healthy subjects, P<0.0001). During a mean follow-up of 43.1±22.0 months, 32 patients died. Abnormal HRR (⩽14 beats) was a strong predictor of mortality in COPD patients (adjusted hazard ratio: 5.12, 95% CI [1.54–17.00]). In conclusion, COPD patients have a lower HRR than healthy subjects, and have a worse prognosis when presenting abnormal HRR.

Keywords

COPD
Survival
Autonomic dysfunction

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This work has been supported in part by the Rx&D Health Research Foundation and the Canadian Institutes of Health Research.