Cardiac rehabilitation and improvement of chronotropic incompetence: Is it the exercise or just the beta blockers?

Pimenta, Tiago; Rocha, José Afonso

doi:10.1016/j.repc.2021.01.014

Cited by 6 publications

(2 citation statements)

References 23 publications

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“…CR is the physiological adaptation of HR to the required activity level [35]. This physiological adaptation has been reported to be a strong and independent predictor of morbidity and mortality [36].…”

Section: Discussionmentioning

confidence: 99%

Chronotropic Response and Risk Factors for Cardiovascular Disease in Patients with Rheumatoid Arthritis: A Cross-Sectional Study

Osailan,

Metsios,

Duda

et al. 2023

JCM

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Background: Individuals with rheumatoid arthritis (RA) are at a high risk of cardiovascular diseases (CVD). A reduced chronotropic response (CR), which produces exercise intolerance, is known to be a contributing factor to CVD and mortality. Studies have shown that patients with RA have a reduced CR. However, knowledge of CR-related factors in patients with RA is limited. This study aimed to explore CR-related factors, including CVD risk factors, inflammatory markers, and cardiorespiratory fitness (VO2PEAK). Methods: A total of 106 RA patients underwent a treadmill test, heart rate monitoring, and various assessments, including serological CVD risk factors, inflammatory markers, and VO2PEAK. Results: A total of 34% of participants demonstrated a reduced CR (≤80%). Body mass index, HOMA, hsCRP, and fibrinogen were inversely related to CR, while HDL, QUICKi, VO2PEAK, and RER exhibited a positive association. HDL and VO2PEAK emerged as independent CR-related factors in regression analysis. Conclusions: The current findings suggest that reduced CR in RA is associated with several CVD risk factors, inflammatory markers, and cardiorespiratory fitness. Future studies should investigate the effects of controlling these associated variables on CR in patients with RA.

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Section: Discussionmentioning

confidence: 99%

Chronotropic Response and Risk Factors for Cardiovascular Disease in Patients with Rheumatoid Arthritis: A Cross-Sectional Study

Osailan,

Metsios,

Duda

et al. 2023

JCM

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“…These findings underscore the importance of timely diagnosis and therapeutic intervention, as chronotropic incompetence not only predicts cardiovascular morbidity and mortality but may also underlie early exercise-related fatigue. Hence, targeted interventions, including cardiopulmonary rehabilitation programs, are vital, as they have shown efficacy in enhancing aerobic capacity and the quality of life for post-COVID patients with chronotropic incompetence 10 . This study, while providing valuable information on chronotropic incompetence in long COVID, has several limitations.…”

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confidence: 99%

Chronotropic incompetence is associated with reduced aerobic conditioning and sedentary behavior in patients with post-acute COVID-19 syndrome

Campos,

Brito,

Santos

et al. 2024

Rev. Inst. Med. trop. S. Paulo

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Post-acute COVID-19 syndrome, or long COVID, presents with persistent symptoms, including cough, dyspnea, and fatigue, extending beyond one month after SARS-CoV-2 infection. Cardiac complications such as chest pain and arrhythmias have raised concerns, with chronotropic incompetence (CI), an inadequate heart rate increase during exercise, emerging as a significant condition contributing to diminished exercise tolerance and quality of life. This study estimated the prevalence of CI and explored its association with aerobic capacity and physical activity levels in long COVID patients. A cross-sectional study was conducted at a private hospital in Sergipe, Brazil, involving 93 patients over 18 years old with persistent post-COVID-19 symptoms after confirmed SARS-CoV-2 infections. Exclusion criteria included beta-blocker use, inadequate respiratory exchange ratio, and inability to complete cardiopulmonary exercise testing (CPET). Clinical histories, CPET results, and chronotropic index calculation were used to identify CI, with logistic regression analyzing associated factors. Of the participants (mean age 45 years; average duration since COVID-19 diagnosis 120 days), 20.4% were diagnosed with CI. Logistic regression identified a strong association between CI and sedentary behavior (OR 11.80; 95% CI 2.54 to 54.78; p=0.001). Patients with CI showed lower predicted peak heart rates and maximal oxygen uptake. The prevalence of CI among long COVID patients in this study was approximately 20%, associated with decreased aerobic capacity and increased sedentary behavior. These findings highlight the need for timely diagnosis and therapeutic interventions, including cardiopulmonary rehabilitation, to enhance the quality of life in post-COVID patients with CI. The study's crosssectional design and its specific context have limited causality inference and generalizability, underscoring the importance of further research in diverse settings.

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Cardiopulmonary Exercise Testing, Rehabilitation, and Exercise Training in Postpulmonary Embolism

Dharmavaram¹,

Esmaeeli²,

Jacobson³

et al. 2023

Interventional Cardiology Clinics

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Cardiac rehabilitation and improvement of chronotropic incompetence: Is it the exercise or just the beta blockers?

Cited by 6 publications

References 23 publications

Chronotropic Response and Risk Factors for Cardiovascular Disease in Patients with Rheumatoid Arthritis: A Cross-Sectional Study

Chronotropic Response and Risk Factors for Cardiovascular Disease in Patients with Rheumatoid Arthritis: A Cross-Sectional Study

Chronotropic incompetence is associated with reduced aerobic conditioning and sedentary behavior in patients with post-acute COVID-19 syndrome

Cardiopulmonary Exercise Testing, Rehabilitation, and Exercise Training in Postpulmonary Embolism

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