title: Association of impaired heart rate recovery with cardiopulmonary complications after lung cancer resection surgery.
abstract: OBJECTIVE
  Patients who undergo lung resection surgery are at risk for postoperative morbidity and mortality. Appropriate selection of the surgical candidate is crucial in the treatment of lung cancer. Heart rate recovery is a measure of physical fitness. We aimed to investigate the association of impaired heart rate recovery with cardiopulmonary complications after lung resection surgery for treatment of lung cancer.
  
  
  METHODS
  Data from consecutive patients who, between 2009 and 2013, underwent heart rate recovery evaluation after 6-minute walk tests before lung resection surgery were retrospectively reviewed. Impaired heart rate recovery was defined as a 12-beat or less decrease in peak heart rate at 1 minute after the 6-minute walk test. Postoperative cardiopulmonary complications were as defined by the Society of Thoracic Surgeons General Thoracic Surgery Database. Logistic regression was performed, including previously known risk factors for postoperative complications after lung resection surgery.
  
  
  RESULTS
  A total of 96 patients had heart rate recovery evaluated within 6 months of lung resection surgery for treatment of lung cancer. Thirty-one patients had impaired heart rate recovery, 17 of whom (55%) had cardiopulmonary complications. A total of 65 patients had normal heart rate recovery, 17 of whom (26%) had cardiopulmonary complications. In multivariable logistic regression analysis, impaired heart rate recovery was significantly associated with postoperative cardiopulmonary complications (odds ratio, 4.97; confidence interval, 1.79-13.8; P = .002). No patient died within 30 days after surgery.
  
  
  CONCLUSIONS
  Impaired heart rate recovery after the 6-minute walk test is associated with postoperative cardiopulmonary complications in patients who underwent lung resection surgery for treatment of lung cancer.
authors.affiliation: Medicine Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address: ducha2011@gmail.com.
authors.forename: Duc
authors.initials: D
authors.lastname: Ha
authors.affiliation: Respiratory Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Humberto
authors.initials: H
authors.lastname: Choi
authors.affiliation: Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Katrina
authors.initials: K
authors.lastname: Zell
authors.affiliation: Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Raymond
authors.affiliation: Radiation Oncology, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Kevin
authors.initials: K
authors.lastname: Stephans
authors.affiliation: Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Xiao-Feng
authors.initials: XF
authors.lastname: Wang
authors.affiliation: Radiation Oncology, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Gregory
authors.initials: G
authors.lastname: Videtic
authors.affiliation: Respiratory Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Kevin
authors.initials: K
authors.lastname: McCarthy
authors.affiliation: Respiratory Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Omar A
authors.initials: OA
authors.lastname: Minai
authors.affiliation: Respiratory Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Mazzone
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D005080:Exercise Test; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D006339:Heart Rate; D006801:Humans; D016015:Logistic Models; D008171:Lung Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011013:Pneumonectomy / Q000009:adverse effects*; D011237:Predictive Value of Tests; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome