Chronotropy

Brubaker, Peter H.; Kitzman, Dalane W.

doi:10.1016/j.jchf.2013.03.009

JACC: Heart Failure

2013

DOI: 10.1016/j.jchf.2013.03.009

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Chronotropy

Peter H. Brubaker

Dalane W. Kitzman

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Cited by 5 publications

(1 citation statement)

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“…Whilst cardiac vagal activity reduces HR after exercise, maximal aerobic exercise is facilitated by increases in HR, principally driven by the sympathetic nervous system 9, 10, 11, 12, 13, 14. The impaired ability to increase HR, 4 which is required for increased activity or demand, is broadly defined as chronotropic incompetence 12 .…”

mentioning

confidence: 99%

Chronotropic incompetence and myocardial injury after noncardiac surgery: planned secondary analysis of a prospective observational international cohort study

Abbott

Pearse

Beattie

et al. 2019

British Journal of Anaesthesia

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Background: Physiological measures of heart failure are common in surgical patients, despite the absence of a diagnosis. Heart rate (HR) increases during exercise are frequently blunted in heart failure (termed chronotropic incompetence), which primarily reflects beta-adrenoreceptor dysfunction. We examined whether chronotropic incompetence was associated with myocardial injury after noncardiac surgery. Methods: This was a predefined analysis of an international cohort study where participants aged !40 yr underwent symptom-limited cardiopulmonary exercise testing before noncardiac surgery. Chronotropic incompetence was defined as the ratio of increase in HR during exercise to age-predicted maximal increase in HR <0.6. The primary outcome was myocardial injury within 3 days after surgery, defined by high-sensitivity troponin assays >99th centile. Explanatory variables were biomarkers for heart failure (ventilatory efficiency slope [minute ventilation/carbon dioxide production] !34; peak oxygen consumption 14 ml kg À1 min À1 ; HR recovery 6 beats min À1 decrease 1 min post-exercise; preoperative N-terminal pro-B-type natriuretic peptide [NT pro-BNP] >300 pg ml À1 ). Myocardial injury was compared in the presence or absence of sympathetic (i.e. chronotropic incompetence) or parasympathetic (i.e. impaired HR recovery after exercise) thresholds indicative of dysfunction. Data are presented as odds ratios (ORs) (95% confidence intervals). Results: Chronotropic incompetence occurred in 396/1325 (29.9%) participants; only 16/1325 (1.2%) had a heart failure diagnosis. Myocardial injury was sustained by 162/1325 (12.2%) patients. Raised preoperative NT pro-BNP was more

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confidence: 99%

Chronotropic incompetence and myocardial injury after noncardiac surgery: planned secondary analysis of a prospective observational international cohort study

Abbott

Pearse

Beattie

et al. 2019

British Journal of Anaesthesia

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The Normal Electrocardiogram

Harris

2016

Critical Care Nursing Clinics of North America

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Chronotropic incompetence of the heart is associated with exercise intolerance in patients with schizophrenia

Herbsleb

Schumann

Malchow

et al. 2018

Schizophrenia Research

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Chronotropy

Cited by 5 publications

References 19 publications

Chronotropic incompetence and myocardial injury after noncardiac surgery: planned secondary analysis of a prospective observational international cohort study

Chronotropic incompetence and myocardial injury after noncardiac surgery: planned secondary analysis of a prospective observational international cohort study

The Normal Electrocardiogram

Chronotropic incompetence of the heart is associated with exercise intolerance in patients with schizophrenia

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