, Volume 105, Issue 1, pp 37-45

Heart rate recovery and prognosis in heart failure patients

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Abstract

The aim of this study is to evaluate the usefulness of heart rate recovery (HRRec) for assessing risk of death in heart failure (HF) patients. Echocardiographic and clinical exercise data were analyzed retrospectively on 712 HF patients (EF ≤ 45%). HRRec was calculated as peak exercise heart rate − heart rate at 1 min of active recovery. Patients were followed for all-cause mortality (5.9 ± 3.3 years follow-up). Groups were identified according to HRRec: group-1 (HRR ≤ 4 bpm), group-2 (5 ≤ HRR ≤ 9 bpm), and group-3 (HRR ≥ 10). Kaplan–Meier analysis estimated survival of 91, 64, and 43% (group-1); 94, 76, and 63% (group-2); and 92, 82, and 70% (group-3) at 1, 5, and 10 years, respectively. Ranked HRRec independently predicted mortality after adjusting for age, gender, NYHA class, LVEF and BMI, but was not independent of exercise time, peak \( V_{{{\text{O}}_{ 2} }} \) and \( V_{\text{E}} /V_{{{\text{CO}}_{ 2} }} \) at nadir. HRRec is a useful prognostic marker in patients with HF, particularly when gas exchange measures are not available.