title: Post-exercise heart rate recovery and mortality in chronic obstructive pulmonary disease.
abstract: 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 1s (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.
authors.affiliation: Centre de recherche, Hôpital Laval, Institut Universitaire de Cardiologie et de Pneumologie de l'Université Laval, Qué., Canada.
authors.forename: Miriam
authors.initials: M
authors.lastname: Lacasse
authors.forename: François
authors.initials: F
authors.lastname: Maltais
authors.forename: Paul
authors.initials: P
authors.lastname: Poirier
authors.forename: Yves
authors.initials: Y
authors.lastname: Lacasse
authors.forename: Karine
authors.initials: K
authors.lastname: Marquis
authors.forename: Jean
authors.initials: J
authors.lastname: Jobin
authors.forename: Pierre
authors.initials: P
authors.lastname: LeBlanc
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000209:etiology* / Q000503:physiopathology; D001342:Autonomic Nervous System Diseases / Q000401:mortality / Q000503:physiopathology*; D015444:Exercise / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume / Q000502:physiology; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality / Q000503:physiopathology*; D012307:Risk Factors; D016019:Survival Analysis