Abstract 15061: Prognostic Value of Post-exercise Heart Rate Recovery in Patients With Acute Decompensated Heart Failure
Background: Post-exercise heart rate recovery (HRR) is an index of parasympathetic function associated with clinical outcomes in patients with chronic heart failure. However, its prognostic value in patients with acute decompensated heart failure (ADHF) is not well investigated.
Methods: We measured HRR (calculated as the difference between heart rate at peak exercise and after 2 minute of recovery) in 98 prospectively and consecutively enrolled ADHF patients (65 male, 60 ± 15 years, mean ejection fraction 28.4 ± 13.9%) at predischarge period. Primary endpoint was cardiovascular (CV) events defined as CV mortality, cardiac transplantation or rehospitalization.
Results: The primary outcome occurred in 26 (26.5%) patients (5 cardiovascular deaths and 7 cardiac transplantations) during follow up period (median 158 days, 5-646 days). When the patients with ADHF were divided by HRR according to Youden index, low HRR (< 22.5) was shown to be associated with poor clinical outcome (p=0.009). Multivariate Cox regression analysis revealed that HRR was found to be an independent predictor of CV events (p=0.029) when controlled for age, hemoglobin, creatinine, NT-proBNP and beta-blocker use.
Conclusion: Post-exercise HRR is an independent prognostic marker in patients with ADHF. These findings may explain the novel relationship between autonomic dysfunction and clinical outcome in these patients.
Author Disclosures: J. Youn: None. N. Hong: None. J. Oh: None. S. Park: None. S. Lee: None. D. Choi: None. S. Kang: None.
- © 2014 by American Heart Association, Inc.