title: Prognostic value of chronotropic incompetence in elderly patients undergoing exercise echocardiography.
abstract: BACKGROUND
  Chronotropic incompetence (CI), defined as failure to achieve less than 80% of age-expected heart rate, is a predictor of mortality and adverse cardiovascular events and may confer a worse prognosis in elderly diabetic individuals.
  
  
  OBJECTIVE
  To evaluate the prognostic value of chronotropic incompetence (CI) in elderly diabetic patients considering endpoints with acute myocardial infarction (AMI), cerebrovascular disease (CVD) and overall mortality and compare clinical and echocardiographic characteristics between patients with and without CI.
  
  
  METHODS
  A total of 298 elderly diabetic patients undergoing exercise echocardiography (EE) were studied from January 2001 to December 2010. Of these, 109 were chronotropic incompetent (group 1) and were compared with the chronotropic competent ones (group 2) regarding the occurrence of cardiovascular events, clinical and echocardiographic characteristics.
  
  
  RESULTS
  Chronotropic incompetents patients showed a higher frequency of cerebrovascular disease (9.2% vs. 3.2, p = 0.027) and higher mortality was observed in those who had cerebrovascular disease or acute myocardial infarction. The presence of typical angina and dyspnea prior to the performance of EE and male gender were more frequent in group 1. Rest and exercise left ventricular wall motion score index, rate of left ventricle mass and left atrium diameter were higher in chronotropic incompetent individuals.
  
  
  CONCLUSIONS
  Chronotropic incompetence was independently associated with the occurrence of cerebrovascular disease in elderly diabetic individuals.
authors: Universidade Federal de Sergipe1; Hospital e Clínica São Lucas2, Aracaju, SE - Brazil. julianasilvasantana@hotmail.com
authors: Juliana Silva
authors: JS
authors: Santana
authors: José Carlos Sizino
authors: JC
authors: Franco Filho
authors: Antônio Arestides de
authors: AA
authors: Sá Neto
authors: Enaldo Vieira de
authors: EV
authors: Melo
authors: Nathalie Oliveira de
authors: NO
authors: Santana
authors: Ana Terra Fonseca
authors: AT
authors: Barreto
authors: Luiza Dantas
authors: LD
authors: Melo
authors: José Augusto
authors: JA
authors: Barreto Filho
authors: Antônio Carlos Sobral
authors: AC
authors: Sousa
authors: Joselina Luzia Menezes
authors: JL
authors: Oliveira
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000401:mortality* / Q000503:physiopathology; D003920:Diabetes Mellitus / Q000000981:diagnostic imaging / Q000401:mortality* / Q000503:physiopathology; D025401:Echocardiography, Stress / Q000379:methods; D004812:Epidemiologic Methods; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D009203:Myocardial Infarction / Q000401:mortality* / Q000503:physiopathology; D005082:Physical Exertion / Q000502:physiology*; D011379:Prognosis; D016277:Ventricular Function, Left / Q000502:physiology